Give Patients What They Want - Results, Stat!

The workload may be heavy, and the time short, but know this: patients want their radiology study results quickly, and many are happy to get those results directly from the radiologist, according to the study “Creating a Patient-Centered Imaging Service: Determining What Patients Want,” published in the March, 2011 issue of the American Journal of Roentgenology.

Researchers from Stanford University School of Medicine’s Department of Radiology surveyed 129 patients who came to their academic outpatient imaging facility in 2008 for CT and MRI scans. Researchers wanted to know whether patients cared who gave them their imaging results and if that answer depended on results being normal or abnormal. They also looked at how quickly the patients wanted their results, and whether timeliness affected their preference of who communicated them.

The results differed slightly for normal and abnormal findings. For normal studies, 33 percent of patients don’t care whether the results come from the referring physician or the radiologist, just who can give the results faster. However, 41 percent of patients would rather get results only from the referring physician, 12 percent prefer the radiologist, and 14 percent want the results from both doctors.

For abnormal results, still 41 percent prefer hearing the news only from the referring physician. Fewer, only 6 percent, want the results from the radiologist alone, while 27 percent want it from both physicians. Another 26 percent want abnormal results from the physician who can give them results the quickest.

“I would have thought more patients would want to hear the results from the primary-care physician,” said Vijay Rao, MD, David C. Levin Professor and chair of radiology at Thomas Jefferson University. “It’s encouraging that less than half only wanted the results from primary care. They trust their physician, who puts everything together, the clinical findings, the X-rays. [The patients] prefer speed over trust or relationship with their clinician. Many patients don’t know who their radiologist is.”

The issue of timeliness and customer satisfaction is one for taking note, since patient expectations may not be in cahoots with current deliverables. While more than 70 percent of patients felt it was acceptable to wait 24 hours to receive normal imaging results, fewer than 60 percent thought the same about receiving abnormal results. Increasing the time to two or three days, about 40 percent felt it was acceptable for normal results, whereas only 20 percent felt that way for abnormal results.

This flies in the face of the reality. The study notes that the average MRI/CT scan turnaround time at academic radiology department facilities in 2009, was more than 33 hours. Researchers said that Stanford’s facility at that time gave results within 18 hours. Study patients completed their survey before getting imaging results, but the 18-hour timing showed patient “acceptable” rates hovering around 70 percent for abnormal results and 85 percent for normal ones.

“The emphasis [now] is to turn around the reports really quickly, within 24 hours,” said Rao. “In the past [doctors] didn’t care about that; clinicians came down and spoke with the radiologist. Now, because of advanced technology, they’re just looking at the images on their computer. Now the reports have to get to the clinicians really quickly.”

Rao said it be unrealistic for the patient to wait at the facility for MRI or CT results, however an effort can be made to convey the information within 24 hours. She doesn’t anticipate that radiologists giving patients results will be a very popular concept, because patient communication takes time. “And radiologists have gotten used to being in front of the computer and churning out cases. Ultimately that type of practice is a detriment to radiology as a specialty,” she said.

The study noted that when radiologists give results to the patients, it not only increases the speed of communication, but it improves patient satisfaction and improves patient follow-up for abnormal results because the loop is closed more quickly. It can also decrease the radiologist’s medical liability.

The article brings up a new or shifting model of patient-centered radiology, where the radiologist is more visible in patient care. Some radiologists are already doing this, like in mammography, where a model is already created. While she said it would be challenging to do this across the board given the volume of testing, Rao said, “We need to make an effort to do it, at least for high-end imaging.” She thought outpatient services would be a good starting place.

The shift takes radiology away from being a commodity, and makes the radiologist seen as a specialist. “For us to really show that we add value, we need to show our value to all our consumers: the hospital, the patients, to the referring physicians,” she said. Rao called the study a “wake-up call for the radiology community - a call to action,” and added that there’s a huge opportunity for radiology to come into the mainstream of patient care.