Elsevier

Academic Radiology

Volume 24, Issue 9, September 2017, Pages 1169-1174
Academic Radiology

Original Investigation
Patients' Use and Evaluation of an Online System to Annotate Radiology Reports with Lay Language Definitions

https://doi.org/10.1016/j.acra.2017.03.005Get rights and content

Rationale and Objectives

The increasing availability of personal health portals has made it easier for patients to obtain their imaging results online. However, the radiology report typically is designed to communicate findings and recommendations to the referring clinician, and may contain many terms unfamiliar to lay readers. We sought to evaluate a web-based interface that presented reports of knee MRI (magnetic resonance imaging) examinations with annotations that included patient-oriented definitions, anatomic illustrations, and hyperlinks to additional information.

Materials and Methods

During a 7-month observational trial, a statement added to all knee MRI reports invited patients to view their annotated report online. We tracked the number of patients who opened their reports, the terms they hovered over to view definitions, and the time hovering over each term. Patients who accessed their annotated reports were invited to complete a survey.

Results

Of 1138 knee MRI examinations during the trial period, 185 patients (16.3%) opened their report in the viewing portal. Of those, 141 (76%) hovered over at least one term to view its definition, and 121 patients (65%) viewed a mean of 27.5 terms per examination and spent an average of 3.5 minutes viewing those terms. Of the 22 patients who completed the survey, 77% agreed that the definitions helped them understand the report and 91% stated that the illustrations were helpful.

Conclusions

A system that provided definitions and illustrations of the medical and technical terms in radiology reports has potential to improve patients' understanding of their reports and their diagnoses.

Introduction

The increasing availability of patient portals—personalized access to the electronic health record—has made it easier for patients to access appointment information, medication lists, and test results online 1, 2, 3, 4. A survey of adult outpatients undergoing imaging within an academic health system revealed that 64% of respondents were interested in receiving an electronic copy of their radiology report in its original form (5). A cross-sectional study of more than 100,000 patients within a single health system demonstrated that 51% of the patients who had access to their radiology reports viewed their reports online (6).

Radiology reports historically have been composed to communicate findings to the ordering physician and guide the next steps in a patient's management (7). Even though patients now can access their imaging reports, they often find it difficult to interpret the medical jargon contained in these results (8). In many cases, they also do not fully appreciate the rationale for undergoing an imaging test (9). Furthermore, the difficulty in understanding reports reviewed online in the absence of a discussion with a physician on the care team may result in miscommunication and unnecessary patient anxiety 10, 11. To mitigate this anxiety, most patient portals release results after a fixed delay to allow ordering physicians to contact patients directly and discuss abnormal test results before patients can view the results online. A survey of referring physicians did not indicate that they experienced an increased workload as a result of the introduction of patient portals or the implementation of the delay in releasing results to patients (12).

Patients who send radiology-related messages to their providers through an electronic portal are most often interested in obtaining the results of their imaging examinations (13). As such, it is becoming increasingly important for radiologists to convey results of imaging examinations such that they are both appropriate for the ordering physician, but also consumable by the patient without a medical background. However, expecting two reports to now accompany every imaging study is not practical. We sought to understand patient sentiment about Patient-Oriented Radiology Reporter (PORTER), a web-based application to annotate reports, that was applied to reports generated for magnetic resonance imaging (MRI) of the knee (14). In this manuscript, we discuss the use and evaluation of this application by patients who accessed and reviewed their annotated reports through PORTER's web-based user interface.

Section snippets

Methods

The organization's institutional review board approved the HIPAA (Health Insurance Portability and Accountability Act) compliant study protocol; informed consent was waived. From August 1, 2015 to February 29, 2016, we included a “Dear Patient” statement in the radiology department's default report template for knee MRI. The statement invited patients to view their report at the PORTER web address (Fig 1). The statement included the examination's accession number, which is an 8-digit number

Results

During the 7-month trial, 185 of 1138 patients (16.3%) opened their report in the viewing portal. Of those, 136 patients (73.5%) opened the report once; seven patients opened their report four or more times. Of patients who logged in, 141 (76.2%) hovered over at least one term to view its definition and spent a mean of 3.2 minutes viewing their reports. The reports viewed contained a median of 50 unique terms and 82 total terms.

Patients viewed definitions of a median of 15 unique terms and 23

Discussion

The Imaging 3.0 initiative sponsored by the American College of Radiology (ACR) recommends that the radiologists be present at every step of the imaging process: before, during, and after the examination (15). ACR also has convened a Commission on Patient- and Family-Centered Care to guide radiology practices to better adhere to these principles. PORTER was developed in an effort to empower patients to become more engaged in their care and to better consume the knowledge within their radiology

References (25)

  • S. Peacock et al.

    Patient portals and personal health information online: perception, access, and use by US adults

    J Am Med Inform Assoc

    (2016)
  • C.W. Arnold et al.

    Imaging informatics for consumer health: towards a radiology patient portal

    J Am Med Inform Assoc

    (2013)
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