Preparing Patients to Read Their Own Radiology Reports
Increasingly, diagnostic imaging providers use web portals to give patients full access to their own radiology reports. Despite early fears that patients would misinterpret complex medical information, leading to unnecessary anxiety, most studies of direct access to radiology reports suggest that this is a positive step for patients and health care providers alike. When patients take a more active role in their care, they provide an extra level of oversight, reducing the chance of an error. Informed patients are also more likely to ask radiologists helpful questions, potentially preventing unnecessary testing.
In order to realize the full benefits of open access, however, primary care physicians or radiologists themselves should start educating their patients on how to read radiology reports. Otherwise, the fears of the opponents of patient access are more likely to be borne out in the patient population.
Here are a few of the key points to emphasize to patients who may be accessing their radiology reports for the first time:
Explaining Radiology Reports to Patients: The Breakdown
Patients may be more comfortable with the radiology report when you explain it section-by-section. Luckily, radiology reports are broken down into six sections, which is a good place to start when explaining the documents to patients. Let patients know that the typical radiology report will include the following: The type of exam performed, the patient’s clinical history, the comparison, the imaging technique, findings, and the radiologist’s final impressions. Encourage patients to ask questions if they encounter anything they don’t understand in any of these six sections:
Section 1: The Basics
Radiology reports that begin with naming the type of exam will explain which imaging modality (MRI, CT, X-ray, etc.) was used in the procedure — and, crucially, which part of the body technologists scanned. They’ll also include the time and date, as well as any details about preliminary procedures, like the use of contrast.
When discussing this first section, make sure patients understand the basics of the modality, and risks involved. This is a good time, for instance, to mention that MRI scans don’t expose patients to ionizing radiation, or that intravenous contrast has a low incidence of negative side effects.
Section 2: The Patient’s Backstory
The “clinical history” section of a report includes information such as the patient’s age, sex, and pre-existing conditions or diseases, and any other relevant medical information needed.
Patients can find the reason for the scan and, often, a suspected diagnosis in this section. This information helps the radiologist focus the report to each patient’s individual medical situation. Conversations with patients about their clinical histories can ensure that physicians have access to all relevant data before referring the patient for diagnostic imaging.
Section 3: Comparing New Scans to Previous Radiology Reports
If the patient has had other imaging done in the past, sometimes those images need to be used as comparisons. The “comparison” section of the typical radiology report is where past images will be mentioned. Typically, radiologists only consult scans of similar regions of the body when making comparison notes.
Section 4: Technical Details
When patients have questions about a radiology report, they often turn up in the “technique” section. Ironically, the details provided here — exact scientific descriptions of the imaging procedure — may not give the referring physician or the patient strongly relevant information.
However, the information contained herein is vital for radiologists, who may need to recreate or alter technical procedures in later scans. In reading through the technique portion of the radiology report, physicians may need to explain medical terminology, such as the use of anatomical planes, as well as structures of the body.
Section 5: The Radiologist’s Findings
This is what every patient wants to know—what was found during a scan. Don’t let patients place too much emphasis on the findings, however; the detailed analysis comes with the radiologist’s impressions, in the final section of the typical radiology report.
Here, radiologists provide their notes on the normality or abnormality of the scanned area. Sometimes, patients don’t see a certain organ or bodily structure that they know was part of the imaging procedure. Let them know that this usually just means the radiologist didn’t find anything worth commenting on in that area. That’s usually good news.
Section 6: The Radiologist’s Diagnosis
The “impression” section of a medical report is where patients will find the radiologist’s diagnosis, along with recommendations for future testing for confirmation. Commonly, radiologists offer differential diagnoses, which include any number of potential causes of the patient’s symptoms. This can be confusing to patients new to reading radiology reports, so it can be helpful to spend extra time discussing each of the diagnoses on the radiologist’s list, and planning for future diagnostics that can uncover the true illness.
The Growth of Portal-Based Radiology Reporting
Even if the diagnostic imaging facilities you refer patients to don’t offer online access to radiology reports, odds are they will in the near future. The latest survey found that nearly 80 percent of patients who responded said they preferred to view radiology reports through online portals compared with more traditional methods of reporting. Tellingly, this includes getting the details verbally from their referring physician.
Another survey of 617 patients found that 64 percent of the study participants said they wanted to review their radiology reports themselves. An impressive 85 percent reported a desire to see the diagnostic images themselves.
In a consumer-driven health care market, these preferences are bound to win out. Prepare patients to read their own radiology reports to improve the efficacy of patient web portals at diagnostic imaging centers.
Cabarrus, M et al. Patients Prefer Results From the Ordering Provider and Access to Their Radiology Reports. Journal of the American College of Radiology. June 2015; 12(6):556-562. DOI: https://doi.org/10.1016/j.jacr.2014.12.009. Accessed March 14, 2018.
Johnson, AJ et al. Access to Radiologic Reports via a Patient Portal: Clinical Simulations to Investigate Patient Preferences. Journal of the American College of Radiology. April 2012; 9(4):256-263. DOI: https://doi.org/10.1016/j.jacr.2011.12.023. Accessed March 14, 2018.
Landro L. Radiologists Push for Medical Reports Patients Can Understand. The Wall Street Journal. September 2014; Web. Available here. Accessed March 14, 2018.
Orenstein B. Reporting to Patients. Radiology Today. January 2013;14(1):22. Available here. Accessed March 14, 2018.
Patients accessing medical records online more than ever. Becker’s Hospital Review. July 2016; Web. Available here. Accessed March 14, 2018.