Traditionally, radiologists have delivered their professional services via written radiology reports. Today, the vast majority of radiology interpretive reports remain word-only, mostly unstructured documents. But sole reliance on the written radiology report appears to be changing.

Innovations in clinical applications of interactive multimedia reporting (IMR) now offer new ways for radiologists to produce and deliver their findings.

Radiologists at NYU Health studied the possibility of producing patient-centered videos of radiology reports and have just shared their initial findings in an article to be published by the American Journal of Roentgenology (AJR). During the four month study, which was conducted in collaboration with Visage Imaging GmbH, the NYU radiology department built and integrated a video reporting tool inside the picture archiving and communication system (PACS) used by the radiologists to read imaging studies. Faculty radiologists created video radiology reports and delivered the video directly to patients and referring providers seamlessly through an integrated patient portal.

The video reports are created by the radiologist who brings the images into the diagnostic viewer screen and then records an audio report using the same microphone the radiologist used to create the traditional, comprehensive written radiology report. The radiologist can use a mouse to identify important anatomical structures. For cross-sectional CT and MRI studies, NYU partnered with Siemens Healthineers to automatically create cinematic rendered (CR) images, which are photorealistic renderings of anatomy. (I urge you to open the article I share in this blog to see an example of an actual video radiology report.)

In large part, such patient-centered reporting is the result of the information blocking provisions of the 21st Century Cures Act which has led a growing number of imaging centers and radiology departments to terminate report embargos and to provide patients immediate access to their written radiology reports. Despite the potential of such immediate access, radiology reports remain highly technical and intended for the patient's physician. Patients are challenged in trying to understand their radiology reports even when they have immediate access.

In a Viewpoints post in February, I described an effort to improve patient understanding of radiology reports, where some imaging centers are beginning to report radiology findings to patients using an interactive web page-style format with diagrams and embedded plain language explanations of medical terms. 

Aside from the perfection of the technology that makes video radiology reports possible, it is necessary to concede that widespread adoption faces the challenges of radiologists who already face, day-in-and-day-out, an overwhelming workload. Radiologists need to be efficient, so any extra time required to generate a video report can be daunting to many interpreting physicians. The AJR article reports that it can take between 2.5 and 6.5 minutes for a radiologist to prepare a video report. The authors acknowledge that continued development will be necessary to further shorten the creation time if the use of video reports becomes more widespread use in daily clinical practice.

Despite the challenges, innovations such as NYU's project to create patient-centered video/audio radiology reporting - as well as the introduction of innovative web-based interactive reporting formats - indicate that radiology has entered a new era of patient engagement. These efforts are bringing remarkable disruptive change to the reporting of radiologists' findings to both patients and their physicians.