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Wednesday, December 04, 2013

Patient-centered Care Goes Beyond Image Interpretation

Mary C. Mahoney, M.D.

Practicing patient-centered radiology can show the healthcare industry—and, most importantly, patients—the value of a radiologist, according to speakers during a special interest session on Monday.

"It's not just about giving results to patients," said Mary C. Mahoney, M.D., chair of RSNA's Patient-Centered Radiology Steering Committee. "It's about considering and optimizing the entire patient experience."

The committee sponsors the RSNA Radiology Cares™: The Art of Patient-centered Practice campaign. The initiative facilitates radiologists' meaningful engagement in the patient experience and encourages radiologists to take the "Radiology Cares" pledge.

"We must portray radiologists as knowledgeable physicians—the imaging experts—and show that we're patient advocates by demonstrating concern and knowledge about safety and risks," Dr. Mahoney said. She and Bibb Allen Jr., M.D., vice-chair of the American College of Radiology (ACR) Board of Chancellors addressed attendees during the session, "Imaging in a New Dimension: Radiologists Add Value," detailing efforts by RSNA and the ACR to make radiology more patient-centered.

Bibb Allen Jr., M.D.

"Many patients don't even know we exist," Dr. Mahoney said. "We can't just be a name on a bill."

One obvious way to become more visible to patients is to deliver results in person, Dr. Mahoney added. "It is a privilege and a responsibility, and an important professional opportunity," she said.

But patient-centered radiology involves more than delivering results, Dr. Mahoney emphasized. She presented a video clip of a referring physician saying she is pleased when a radiologist takes the time to call and question an order and make recommendations for a more appropriate procedure.

Scheduling, results reporting, billing and even design of the reception room, along with interactions with the radiology team, have an impact on the patient experience, Dr. Mahoney said. Registration, scheduling and instructions should be a one-stop process, she said, encouraging radiologists to consider options like Web-based scheduling.

"You can create a 'patient lounge' rather than a 'waiting room,'" Dr. Mahoney explained. "There may be little difference in principle, but providing a comfortable experience can go a long way."

For example, during peak times, radiologists can create a concierge-like experience with a greeter who could also handle issues like unanticipated delays and make sure the patients are comfortable, she said.

Radiologists Should "Own All Aspects of Medical Imaging"

William T. Thorwarth Jr., M.D.

Optimizing the entire patient experience means that radiologists need to go beyond image interpretation and get involved in the imaging process before and after exams, Dr. Allen said in his presentation, "Imaging 3.0: A Framework for Radiologists' Future." But for a number of reasons, most radiologists are not providing that full spectrum of care, he said.

"If we did that, the results would be improved patient safety and outcomes, more cost-effective care, and an increased relevance for radiologists in the healthcare system," Dr. Allen said. "We would have a measurable role for radiologists in improving population health and we would have a calculation of radiology's value in reducing per capita cost."

Session moderator William T. Thorwarth Jr., M.D., RSNA Board Liaison for Publications and Communications, observed, "We have the most sophisticated tools ever available to care for our patients, yet these tools make abnormalities so conspicuous and display them in such anatomic detail, that other specialties believe that they too can do what we do."

Dr. Allen added, "Radiologists need to own all aspects of medical imaging, providing all care that is necessary and no care that is not." He explained that "Imaging 3.0" is a blueprint for high-value care. "It goes beyond interpretations," he said. "It's about assuring appropriateness, documenting the quality and safety radiologists provide, actionable reporting with evidence-based follow-up, and empowered patients."

Dr. Mahoney encouraged radiologists to utilize resources that will improve the patient experience, like RadiologyInfo.org, the RSNA-ACR public information website that provides patients with easy access to understandable descriptions of complex radiology procedures, and to get involved in patient-focused projects like RSNA Image Share, which enables patients to take control of sharing their medical imaging reports via a cloud-based edge server.

Dr. Allen started Monday's question-and-answer session with a challenge. "We more or less developed these ideas—Radiology Cares and Imaging 3.0—independently. We think this is a good vision for our specialty. But I'd like to ask you: Are we wrong? Is this the direction you'd like the specialty to take?"

One audience member responded that the ideas and the values are sound, but that at his institution there was "not much traction" for developing a value case for radiology. Dr. Allen acknowledged that institutional boundaries can make it difficult for radiologists to change their culture. To help spur change, radiologists must achieve the imperatives of healthcare reform, he said. He urged radiologists to avail themselves of point-of-care IT tools like ACR Select, which can make standards-based recommendations within a report, helping radiologists deliver reports that result in measurable outcomes.

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© 2013 RSNA. The RSNA 2013 Daily Bulletin is the official publication of the 99th Scientific Assembly and Annual Meeting of the Radiological Society of North America. Published Sunday, December 1 - Thursday, December 5.

The RSNA 2013 Daily Bulletin is owned and published by the Radiological Society of North America, Inc., 820 Jorie Blvd., Oak Brook, IL 60523.

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