Transcript Patient-Centered Radiology

Sponsored by the
Patient-Centered Radiology Steering Committee
of the Radiological Society of North America
[ Insert organization name ]
Rev 2014
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Overview

Why should we, as radiologists, be
patient-centered?

How can radiologists be patient centered?

Implementing patient centered practices:
Practice management examples

Resources
Why Should We, As Radiologists,
Be Patient-centered?
“…patients’ expectations have changed. Most
patients want to talk with their health care providers
and to play an active role in health care decisions.
“…Yet despite revolutionary technological advances
that are resulting in high-spatial-resolution anatomic
imaging, radiologists are still entrenched in the
historic cultural practice of communicating with
referring physicians only and not with patients.”
Gary M. Glazer, M.D. and Julie A. Ruiz, PhD.
Radiology 2006; 241:11-16
“By default if not by design, the consumer
is emerging as the locus of priority setting
in healthcare.”
JC Robinson, PhD. UC Berkeley
“To transform the current public misperception
about our profession, the distance between
patient and radiologist must be bridged.
Patients acquire their value judgments largely
through personal interactions with individual
medical professionals.”
Arl Van Moore Jr, MD
Former Chair of the ACR Board of Chancellors
Statement Excerpt From The
Coalition for Patient-Centered Imaging
“The Coalition represents the undersigned healthcare
organizations committed to ensuring that patients have full
access to high quality, convenient, and up-to-date imaging
technology … organized in response to efforts to limit the
availability of imaging services provided in physicians’ offices
… such as obstetricians/gynecologists, neurologists,
orthopedic surgeons, cardiologists and urologists.”
http://www.acc.org/advocacy/advoc_issues/imaging_021005.htm
“Keeping medical imaging in the hands of
physicians who treat patients is critical since it
allows them to use their detailed knowledge of the
patients’ medical history and specialized training to
produce the most effective treatment plan possible.”
Mark Gittleman, M.D.
“Keeping medical imaging in the hands of
physicians who treat patients is critical since it
allows them to use their detailed knowledge of the
patients’ medical history and specialized training to
produce the most effective treatment plan possible.”
Mark Gittleman, M.D.
He is a breast surgeon.
Why Should We, As Radiologists,
Be Patient-centered?
An ACR Survey in 2008 indicated that:

Less than 50% of patients believe that radiologists
are healthcare professionals who administer imaging
tests

Less than 50% understand that radiologists are
licensed physicians
How Can Radiologists Be
Patient-centered?
“It’s time we adjust our perception of how we
see ourselves and, more importantly, how
we’re seen by the medical community and
general public. We need to vigorously
promote ourselves in order to attract referrals
from primary care physicians and those
patients who are self-referred. We must
change the perception that we are consultants
only and demonstrate our ability to provide
complete patient care.”
Harvey Neiman, M.D.
ACR Bulletin 2002
How Can Radiologists Be
Patient-centered?
1.
Be visible to patients and referring clinicians
How Can Radiologists Be
Patient-centered?
By being visible, you:
o
Give radiologists a face and demonstrate the
value-added service we provide for the healthcare team
o
Portray that radiologists are imaging experts and
knowledgeable physicians
o
Show that radiologists are patient advocates
o
Demonstrate concern and knowledge about patient
safety and radiation risks.
How Can Radiologists Be
Patient-centered?
1.
Be visible to patients and referring clinicians
2.
Provide timely interpretation for patients and
referring clinicians
How Can Radiologists Be
Patient-centered?
1.
Be visible to patients and referring clinicians
2.
Provide timely interpretation for patients and
referring clinicians
3.
Consider giving results to patients in person
Sick and Scared, and Waiting, Waiting, Waiting
By Gina Kolata
Published: August 20, 2005
“Freddie Odlum spent two terrible days waiting by the phone for her
doctor to call. She had had a CT scan to investigate a suspicious
mass in her lungs and Ms. Odlum, a Los Angeles breast cancer
patient, was all too aware that if the cancer had spread, her prognosis
would not be good.
“But her doctor did not call [for several weeks]. … The scan did not
show cancer, but she could not forgive her doctor. ‘This internist had
been my family doctor for years,’ Ms. Odlum said. … ‘I never spoke to
him again.’”
Kolata, G. (2005). Sick and Scared, and Waiting, Waiting, Waiting. The New York Times.
Sick and Scared, and Waiting, Waiting, Waiting
By Gina Kolata
Published: August 20, 2005
Patients expect
timely results
“Freddie Odlum spent two terrible days waiting by the phone for her
doctor to call. She had had a CT scan to investigate a suspicious mass
in her lungs and Ms. Odlum, a Los Angeles breast cancer patient, was
all too aware that if the cancer had spread, her prognosis would not be
good.
But her doctor did not call [for several weeks]. … The scan did not show
cancer, but she could not forgive her doctor. ‘This internist had been my
family doctor for years,’ Ms. Odlum said. … ‘I never spoke to him
again.’”
Kolata, G. (2005). Sick and Scared, and Waiting, Waiting, Waiting. The New York Times.
Providing Results Directly
To Patients Is Possible
Survey of 261 patients:

92% wanted to be told of normal results by their
radiologist

87% wanted to be told of abnormal results by
their radiologist
Schreiber MH, Leonard Jr M, Youmans Rieniets C.
Disclosure of Imaging Findings to Patients Directly by Radiologists: Survey of Patients’ Preferences.
American Journal of Radiology 1995; 165:467-469
Providing Results Directly
To Patients Is Possible

Majority of test results are normal, or do not
indicate life threatening conditions

96% of 287 patients: test normal, or
non-malignant condition
Vallely SR, Manton Mills JO. Should Radiologists Talk to Patients?
British Medical Journal 1990; 300:305-306
Reality Of Conveying Results

In 2003, there were 1,275,300 newly diagnosed cases
of cancer, and 23,345 radiologists

Even if every case is diagnosed by a radiologist,
that is one abnormal result per week per radiologist
American Cancer Society (http:www.cancer.org)
Pasko T, Smart D. Physician Characteristics and Distribution in the U.S. JAMA 2005; 1
Reality Of Conveying Results

Is a privilege and a responsibility
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Must be customized for each radiologist’s environment

Preferences of referring clinicians should be elicited
prior to initiating a results-communication program

Is an important professional opportunity
How Can Radiologists Learn
To Be More Patient-centered?
Participate In The
Radiology Cares® Campaign
Radiology Cares®:
The Art of Patient-Centered Practice
Vision
Patients are the primary focus of
radiologic care.
Mission
The Radiology Cares® campaign
mission is to encourage and facilitate
radiologists’ meaningful engagement
in the patient experience.
RadiologyCares.org
Implementing
Patient-centered Practices:
Practice management examples
Patient-centered Radiology
The components:
Scheduling
Registration
Billing
Results
Reporting
http://www.hoaghospital.org/radiology/
PATIENT-CENTERED
EXPERIENCE
Reception
Caregiver
Interactions
Patient-centered Radiology
The components:
Scheduling
Registration
Billing
Results
Reporting
http://www.hoaghospital.org/radiology/
PATIENT-CENTERED
EXPERIENCE
Reception
Caregiver
Interactions
Scheduling

Is the correct exam scheduled?

Are proper preparation instructions given to the patient?

How quickly can you get the patient into your office to be examined?
o
Back-logs will induce consumers to shop around for other
providers

Do you offer web-based scheduling?

Registration, scheduling, and instructions must be a one-stop process
Patient-centered Radiology
The components:
Scheduling
Registration
Billing
Results
Reporting
http://www.hoaghospital.org/radiology/
PATIENT-CENTERED
EXPERIENCE
Reception
Caregiver
Interactions
Perception Is Reality…
Waiting Room
“LOUNGE”
Reception

Construct a “patient lounge” rather than a “waiting
room”
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Provide a concierge-like experience with a greeter
during peak volumes
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Attend to consumer inconveniences, such as
unanticipated delays
Patient-centered Radiology
The components:
Scheduling
Registration
Billing
Results
Reporting
http://www.hoaghospital.org/radiology/
PATIENT-CENTERED
EXPERIENCE
Reception
Caregiver
Interactions
Caregiver Interaction

Technologists must have a consistent, friendly,
professional demeanor
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Does the patient get to talk to the radiologist before
or after the exam?

Better yet, does the patient have an option to review
with the radiologist?

Does the patient feel like they’ve received the best
exam possible at an optimized/safe radiation dose?
Patient-centered Radiology
The components:
Scheduling
Registration
Billing
Results
Reporting
http://www.hoaghospital.org/radiology/
PATIENT-CENTERED
EXPERIENCE
Reception
Caregiver
Interactions
Results Reporting

Perhaps the most attractive area of opportunity for
radiologists

With the appropriate information technology, patients
should be able to walk out of the office with a copy of
the report

Provide a cloud server image sharing service so
patients can easily access and share images online
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Make results electronically available and text or call
patients when their report is ready
Results Reporting
For Referring Clinicians:

Offer embedded images in the report
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Provide a results notification system so that referring
clinicians know immediately when their patients’
imaging results are available

Be readily available for questions regarding the
results of a study
Patient-centered Radiology
The components:
Scheduling
Registration
Billing
Results
Reporting
http://www.hoaghospital.org/radiology/
PATIENT-CENTERED
EXPERIENCE
Reception
Caregiver
Interactions
Billing

Notify patients of out-of-pocket expenses at time of
scheduling

Accuracy of billing is a critical factor in becoming a
high-performing, patient centered imaging center

Provide transparent pricing, as patients (healthcare
consumers) will pay attention to price
Resources

Radiologist resource for patient-centered care
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Access to related scientific and consumer media articles

Available customizable presentation decks

Source to take the Radiology Cares® pledge in support
of patient-centered practices
Take The Pledge
An Available Quality Patient
Communication Resource:

www.RadiologyInfo.org

Reassures patients and saves physician time

Free, credible radiology information
in lay language

Over 135 radiologic procedures and
disease/condition descriptions

Tells your patients what to expect

Reviewed by radiologists (RSNA and ACR)

Available in both English
and Spanish
“Success breeds persistence bordering
on perseveration in what we do well despite
very obvious threats, at the expense of
adaptability and innovation. Innovation
requires a conscious, purposeful search for
opportunities.”
Michael Brant-Zawadzki, M.D. and Robert Kerlan Jr., M.D.
Academic Radiology. 2009
Promote And Practice
Patient-Centered
Radiology
Patient-centered Radiology Presentation
Contributors

Mary C. Mahoney, M.D.

Carol M. Rumack, M.D.

Matt Hawkins, M.D.

Eric J. Stern, M.D.

Philip O. Alderson, M.D.

Joseph H. Tashjian, M.D.

Michael Brant-Zawadzki, M.D.

Susan D. John, M.D.

Marcy A. Brown, A.R.R.T

Harvey L. Neiman, M.D.