Imaging Sharing Patient Portals Gaining Ground

Your patients want to view their medical images, and the federal government - through the meaningful use program - suggests they're going to get them.

So the big question becomes how should they get those images? Vendors are making a push for a next generation of patient portals, saying they can reduce costs, increase patient satisfaction and eliminate wasteful duplicate imaging.

"We started looking at patient portals about two years ago," said Cristine Kao, worldwide marketing manager for Carestream Health. "This is the right time."

That's in part due to how technology has advanced - and how comfortable the general public has gotten with that technology. With Carestream's portal, Kao said, "There's no dedicated training required. You know where to log on, you know where to navigate right away. It's like iTunes: You kind of open it up and you intuitively know how to organize and do what you need to do."

Sound like a bold claim? Carestream just completed a case study with Houston Medical Imaging. In all, 1,500 patients activated their image portal account and used it to view and share images. During the three-month case study, Kao said, they received only 47 calls for technical support.

Portals use zero-download clients so nothing has to be installed on a patient's computer. They just log in to a website, click on a folder and get the images they want. When they log out, the images are gone. Nothing is stored on their computer.

But that ease of use makes some physicians nervous. What if patients see the images before the doctor does? Don't panic: Vendors have taken that fear into account.

"One of the things we talked about with a lot of customers was setting up business rules so that either a certain amount of time would elapse or we would get some kind of notification from the referring physician to release the image," said Erica Agran, senior director of solutions management at Merge Healthcare, which has two portal solutions and another concept in the works. "We're not suggesting that we make the rules on delivering the image. We’re just suggesting that we can deliver the image and enable patients to share images."

That sharing is key. The easier it is to see an image, the less likely you are to have to repeat a study. "I have had the personal experience of getting a CD of an image and going for a follow-up right away," Agran said. "They told me they couldn't read the CD and they did the ultrasound again. ... You don't have that problem if you have an electronic copy."

Portals don't just make life easier for patients. They can also cut down on work in your practice. "If you think about how PACS have changed the film-based workflow for the clinician, this is sort of equivalent by taking film or manual media like CDs or DVDs away from the front desk staff and the administrators of the facility," Kao said.

You do have to adjust the workflow in your practice to allow time to educate patients about how to register and use the portals. But at Houston Medical Imaging, the time and costs saved from dealing with CDs outweighed the time spent on education. The case study estimated a cost savings of $7.69 per exam using the portal versus distributing CDs.

But Agran cautions that simply giving patients access to their images isn't enough. "It's not just as easy as giving someone a password," she said. "You still have to explain to patients what they're going to see, what information they're going to get. The technology is there, but there's still that translation that needs to occur."

And as compelling as a patient image portal is to radiology practices, they're just as appealing to other medical facilities, Agran said. "I think the real challenge here is there are too many things you're supposed to sign up for and sign into. For the majority of customers going into a radiology center, they're only going to go once in a while. If you're just going once a year or every other year, it's a challenge for the radiology's portal to mean anything to you."

That's why an ideal solution would aggregate all patent records, Agran said. Merge debuted the merge.com concept at RSNA: "You can do your scheduling, you can get your images, you can come back later and look for things - it doesn't matter if it was a test with your orthopedic surgeon or your mammogram," Agran said.

Both Merge and Carestream plan to roll out their image portals more widely in the coming months. Carestream's solution will be widely available in March, while Merge plans to beta-test the merge.com concept in a small market later this year.