Making Medical Imaging Transparent

John Commins, for HealthLeaders Media , April 3, 2012

Dumb down the data
Mendelson says he is not overly concerned that radiologists might have to alter the case notes they provide for imaging in electronic medical records to account for patient access.

"We believe patients are entitled to see their reports, but it will be a balancing act," he says. In the long run, he says the process will improve communication and efficiency.

"As more patients leverage seeing their results, will there be a feedback loop? Where will  radiologists get more demand on their time to deal with patients? Will they find ways to rephrase things to generate fewer questions? That may well happen. But I wouldn't call it 'dumbing down' as much as finding the appropriate phrasing."

As an additional safeguard—at least initially—the RSNA Image Share network has a 72-hour delay on releasing new medical images to the patient until results and images can be communicated to the referring physicians. The delay was designed in part to protect patients from potentially devastating or confusing news without a ready interpretation of the data.

Mendelson acknowledges that the program designers knew such a delay would be controversial "because there were times when people needed these things instantaneously."

However, he says, the system designers also were being pragmatic.

"When we set this up initially we knew that we couldn't do everything in one fell swoop perfectly. We had to set priorities," he says. "The 72 hours was something that we recognized would require further refinement. We wanted to get the programming right for moving images around first. Now we can come back and revisit things that need to be a little more granular."

For Eytan, patient access to medical imaging is inevitable and part of the greater move toward access and transparency in healthcare delivery. Rather than debating the pros and cons of that patient access, Eytan says physicians should spend their time trying to make it work.

"It's not the 'if,' it's the 'how,'" he says. "This should be done, and the 'how,' I have learned, is everyone needs to be involved. The subspecialty of radiology is very important so this should not be done without their involvement. If we allow them to be involved, they will do a great job with primary care doctors to make this happen."

This article appears in the March 2012 issue of HealthLeaders magazine.

Reprint HLR0312-5

John Commins is a senior editor with HealthLeaders Media.
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