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The evolution of radiology results communications -- the march toward patient-centered reporting

Two events triggered the transformation of the reporting of interpretive findings by radiologists from being focused solely on the patient's treating physician: 1) The passage of the Mammography Quality Standards Act (MQSA) in 1999, which was the first time there was a mandate for direct communication of mammography results to patients via a report written in lay language; and 2) a growing body of case law findings in various state courts arising from allegations that the radiologists' legal duty to patients extended beyond accurate findings to also include a duty to communicate significant findings.

That history and the evolution toward patient-centered radiology reporting is exceptionally well described in a new article from a team at Hofstra/Northwell in an article published online on July 3, 2022 by Clinical Imaging. The beginning of the movement to change the recipients of radiology reports was captured nicely in a 1977 prediction made by my friend, Dr. Leonard Berlin: “Radiologists can and should remain the doctor's doctor; but whether they like it or not, courts and lawmakers are slowly and progressively requiring them to be the patient's doctor as well."

The authors report that the information blocking provisions of the 21st Century Cures Act have led a growing number of hospital radiology departments and imaging centers to begin providing patients immediate access to their radiology reports. Despite the growing availability of such immediate access, the radiology report remains a highly technical document historically intended exclusively for the medical discernment of the patient's physician. Consequently, patients can easily misunderstand their radiology reports even when they have prompt access those reports.

To improve patient understanding, the authors cite several examples of reform in radiology reporting as more patients gain rapid access to the reports describing their radiologist's findings as well as the actual radiological images. They describe how some radiology departments are beginning to place a short summary statement written using lay language at the bottom of each report. Some departments are going so far as to begin providing radiologists' contact information (phone number or email address) on the report itself. And the growing use of "structured reporting" strives to make the findings sections of reports clear and concise, and improve the impression section of those reports to become more definitive and actionable.

Most exciting to me are the radiology departments and imaging centers that are beginning to provide radiology reports to patients in an interactive web page-style format with diagrams and embedded plain language explanations of medical terms. Using software to analyze radiology report text and making use of natural language processing, these new interactive reports help identify and annotate medical terms and phrases which are linked to plain language explanations. Patient-centered definitions and diagrams are viewable alongside the report within a self-contained interface. Quite a change from the era when Dr. Berlin made his insightful prediction!

For a thorough and comprehensive summary of the rapidly evolving patient-centered focus of radiology reporting, I recommend that you read this article. The article has a paywall, but I am glad I purchased the article. It put this movement into a very helpful and comprehensive framework for me.

To meet modern patient expectations and legal requirements, the structure and purpose of the radiologist report is changing.

Tags

health care & life sciences, diagnostic radiology, patient centered care

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