Radiology and patient communication: if not now, then when?

Radiologist-patient communication of musculoskeletal ultrasonography results: a choice between added value and costs

BACKGROUND

Literature on radiologist-patient communication of musculoskeletal ultrasonography (US) results is currently lacking.

PURPOSE

To investigate the patient's view on receiving the results from a radiologist after a musculoskeletal US examination, and the additional time required to provide such a service.

MATERIAL AND METHODS

This prospective study included 106 outpatients who underwent musculoskeletal US, and who were equally randomized to either receive or not receive the results from the radiologist directly after the examination.

RESULTS

In both randomization groups, all quality performance metrics (radiologist's friendliness, explanation, skill, concern for comfort, concern for patient questions/worries, overall rating of the examination, and likelihood of recommending the examination) received median scores of good/high to very good/very high. Patients who had received their US results from the radiologist rated the radiologist's explanation and concern for patient questions/worries as significantly higher (P = 0.009 and P = 0.002) than patients who had not. In both randomization groups, there were no significant differences between anxiety levels before and after the US examination (P = 0.222 and P = 1.000). Of the 48 responding patients, 46 (95.8%) rated a radiologist-patient discussion of US findings as important. US examinations with a radiologist-patient communication regarding US findings (median = 11.29 min) were significantly longer (P < 0.0001) than those without (median = 8.08 min).

CONCLUSION

Even without communicating musculoskeletal US results directly to patients, radiologists can still achieve high ratings from patients for their communication and empathy. Nevertheless, patient experience can be further enhanced if a radiologist adds this communication to the examination. However, this increases total examination time and therefore costs.

Communicating with patients in the age of online portals-challenges and opportunities on the horizon for radiologists

The deployment of electronic patient portals increasingly allows patients throughout Europe to consult and share their radiology reports and images securely and timely online. Technical solutions and rules for releasing reports and images on patient portals may differ among institutions, regions and countries, and radiologists should therefore be familiar with the criteria by which reports and images are made available to their patients. Radiologists may also be solicited by patients who wish to discuss complex or critical imaging findings directly with the imaging expert who is responsible for the diagnosis. This emphasises the importance of radiologists’ communication skills as well as appropriate and efficient communication pathways and methods including electronic tools. Radiologists may also have to think about adapting reports as their final product in order to enable both referrers and patients to understand imaging findings. Actionable reports for a medical audience require structured, organ-specific terms and quantitative information, whereas patient-friendly summaries should preferably be based on consumer health language and include explanatory multimedia support or hyperlinks. Owing to the cultural and linguistic diversity in Europe dedicated solutions will require close collaboration between radiologists, patient representatives and software developers; software tools using artificial intelligence and natural language processing could potentially be useful in this context. By engaging actively in the challenges that are associated with increased communication with their patients, radiologists will not only have the opportunity to contribute to patient-centred care, but also to enhance the clinical relevance and the visibility of their profession.

What radiologists need to know about patients' expectations: P.A.T.I.E.N.T.S C.A.R.E.R.S A.I.M.S

The Patient Advisory Group (PAG) of the European Society of Radiology aims to highlight, in this short paper, patients’ expectations from the radiological community and support workers, throughout the patient’s medical imaging journey for completion of diagnostic or interventional examinations. In order to maintain constant awareness of patients’ expectations, key expectations have been summarised in an easy-to-remember mnemonic: PATIENTS CARERS AIMS.

Due to disparate healthcare systems and medical imaging services in Europe, not all patient expectations can be systematically met, but healthcare providers should be mindful, when setting up new operational procedures, of the need to focus on patient-centred needs and care. At times when new or improved technology is being introduced, such as artificial intelligence applications, telemedicine, robotisation of interventional procedures and digitised records, the impact on radiologist–patient communication and interactions should be considered.

Human, All Too Human? An All-Around Appraisal of the "Artificial Intelligence Revolution" in Medical Imaging

Artificial intelligence (AI) has seen dramatic growth over the past decade, evolving from a niche super specialty computer application into a powerful tool which has revolutionized many areas of our professional and daily lives, and the potential of which seems to be still largely untapped. The field of medicine and medical imaging, as one of its various specialties, has gained considerable benefit from AI, including improved diagnostic accuracy and the possibility of predicting individual patient outcomes and options of more personalized treatment. It should be noted that this process can actively support the ongoing development of advanced, highly specific treatment strategies (e.g., target therapies for cancer patients) while enabling faster workflow and more efficient use of healthcare resources. The potential advantages of AI over conventional methods have made it attractive for physicians and other healthcare stakeholders, raising much interest in both the research and the industry communities. However, the fast development of AI has unveiled its potential for disrupting the work of healthcare professionals, spawning concerns among radiologists that, in the future, AI may outperform them, thus damaging their reputations or putting their jobs at risk. Furthermore, this development has raised relevant psychological, ethical, and medico-legal issues which need to be addressed for AI to be considered fully capable of patient management. The aim of this review is to provide a brief, hopefully exhaustive, overview of the state of the art of AI systems regarding medical imaging, with a special focus on how AI and the entire healthcare environment should be prepared to accomplish the goal of a more advanced human-centered world.

Direct communication between radiologists and patients improves the quality of imaging reports

OBJECTIVES

We investigate in what percentage of cases and to what extent radiological reports change when radiologists directly communicate with patients after imaging examinations.

METHODS

One hundred twenty-two consecutive outpatients undergoing MRI examinations at a single center were prospectively included. Radiological reports of the patients were drafted by two radiologists in consensus using only the clinical information that was made available by the referring physicians. Thereafter, one radiologist talked directly with the patient and recorded the duration of the conversation. Afterwards, the additional information from the patient was used to reevaluate the imaging studies in consensus. The radiologists determined whether the radiological report changed based on additional information and, if yes, to what extent. The degree of change was graded on a 4-point Likert scale (1, non-relevant findings, to 4, highly relevant findings).

RESULTS

Following direct communication (duration 170.9 ± 53.9 s), the radiological reports of 52 patients (42.6%) were changed. Of the 52 patients, the degree of change was classified as grade 1 for 8 patients (15.4 %), grade 2 for 27 patients (51.9%), grade 3 for 13 patients (25%), and grade 4 for 4 patients (7.7%). The reasons leading to changes were missing clinical information in 50 cases (96.2%) and the lack of additional external imaging in 2 cases (3.8%).

CONCLUSIONS

Radiologists should be aware that a lack of accurate information from the clinician can lead to incorrect radiological reports or diagnosis. Radiologists should communicate directly with patients, especially when the provided information is unclear, as it may significantly alter the radiological report.

KEY POINTS

• Direct communication between radiologists and patients for an average of 170's resulted in a change in the radiological reports of 52 patients (42.6%). • Of the 42.6% of cases where the reports were changed, the alterations were highly relevant (grades 3 and 4) in 32.7%, indicating major changes with significant impact towards patient management.