In a 2015 issue of the Journal of the American College of Radiology1
, authors from NYU Langone Medical Center reported their survey results related to patients’ understanding of their own imaging exams.
- 45.8% of patients correctly identified if their exam included radiation
- 72% were satisfied with the referring doctor’s explanation of the exam
- 18.8% indicated unanswered questions
- 52% expressed they had a desire to speak with a radiologist in advance of their exam
On the heels of this study comes a recent report from MD Anderson2
related to oncology patient perceptions of the use of ionizing radiation in diagnostic imaging. Patients responding to the MD Anderson survey had undergone an average of 8.8 imaging procedures in the prior three years, and were asked about CT, MRI, PET, X-ray, cardiac catheterization, mammograms, and ultrasound exams. Despite the fact that presumably these patients were experienced radiology customers who had been informed about radiation risk many times, the authors reported that:
- Only 21.7% of patients said they knew the definition of ionizing radiation
- Overall, 35.1% stated that CT used it
- 29.4% said MRI used it
- 40.9% incorrectly identified sterility as a risk
- 20.9% incorrectly identified acute radiation sickness as a risk
- 39% of respondents indicated that all of these medical imaging tests use ionizing radiation and an equal percent said none of these tests use ionizing radiation
- Of those respondents who claim to have knowledge of ionizing radiation, 48% incorrectly stated MRI uses it, yet only 7.4% said cardiac catheterization uses it
These publications reveal the low level of health literacy in our population and the ineffectiveness of our current, mostly verbal means of communication with patients. Even when patients are motivated to seek medical information, they may be bombarded with non-credentialed information available on the web. Perhaps the most important lesson to be learned in my view: If you are not providing your patients accurate information in a written and memorable form, you are helping them make uninformed or inaccurately informed healthcare decisions.
Fortunately, patients seem to instinctively realize that they need more information from medical imaging specialists. A 2009 study reported that patients were generally dissatisfied with current radiology communication methods, found waiting for results was stressful, desired results in writing, preferred on-line access, and wanted to speak directly with radiologists.3
Quotes from patients included:
“I think the waiting and not knowing anything is the worst.”
“My expectation was that I would leave there with some understanding at least. And it was very disappointing, very disheartening to be told ‘Oh, we don’t give results.’”
“I figured if it was life-threatening or something, somebody would have called me by now….So I’m just figuring that no news is good news.’”
“I think the waiting and not knowing anything is
These sentiments are substantiated by other studies that repeat the same message: most patients want their reports, they want electronic access, and they want to speak with the imaging specialist. Furthermore, a 2015 study reported that 88% of referring physicians found that releasing radiology reports to patients was useful. Referring doctors in that study from Kaiser Permanente reported that follow-up emails, telephone calls, and office visits were unchanged or decreased as a result of releasing imaging reports.4
So, what can medical imaging providers learn from these publications?
- Give your patients what they want. Prompt delivery of their radiology reports.
- Work with your referring staff to help them understand the benefits of prompt report delivery directly to patients. Will this cause an occasional problem? Of course. Still, in healthcare, we implement things when the benefits outweigh the risks.
- Implement technology and service that will help patients communicate with imaging specialists before and after the visit.
These logical and simple suggestions can help build a practice and a culture of health information transparency, thus raising the health literacy of our communities as well as overall patient satisfaction.
1. Rosenkrantz AB, Flagg ER. Survey-Based Assessment of Patient’s Understanding of Their Own Imaging Examinations. J Am Coll Radiol 2015;12:549-555.
2. Steele, JR et al. Oncology Patient Perceptions of the Use of Ionizing Radiation in Diagnostic Imaging. J Am Coll Radiol 2016;13:768-774.
3. Johnson AJ et al. Insight From Patients for Radiologists: Improving Our Reporting Systems. J Am Coll Radiol 2009;6:786-794.
4. Henshaw D et al. Access to Radiology Reports via an Online Patient Portal: Experiences of Referring Physicians and Patients. J Am Coll Radiol 2015;12:582-586.