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Kim M, Lovett JT, Doshi AM, Prabhu V. Immediate Access to Radiology Reports: Perspectives on X Before and After the Cures Act Information Blocking Provision. J Am Coll Radiol 2024; 21:1130-1140. [PMID: 38147904 DOI: 10.1016/j.jacr.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The 21st Century Cures Act's information blocking provision mandates that patients have immediate access to their electronic health information, including radiology reports. We evaluated public opinions surrounding this policy on X, a microblogging platform with over 400 million users. METHODS We retrieved 27,522 posts related to radiology reports from October 5, 2020, through October 4, 2021. One reviewer performed initial screening for relevant posts. Two reviewers categorized user type and post theme(s) using a predefined coding system. Posts were grouped as "pre-Cures" (6 months before information blocking) and "post-Cures" (6 months after). Descriptive statistics and χ2 tests were performed. RESULTS Among 1,155 final posts, 1,028 unique users were identified (64% patients, 11% non-radiologist physicians, 4% radiologists). X activity increased, with 40% (n = 462) pre-Cures and 60% (n = 693) post-Cures. Early result notification before referring providers was the only theme that significantly increased post-Cures (+3%, P = .001). Common negative themes were frustration (33%), anxiety (27%), and delay (20%). Common positive themes were gratitude for radiologists (52%) and autonomy (21%). Of posts expressing opinions on early access, 84% favored and 16% opposed it, with decreased preference between study periods (P = .006). More patients than physicians preferred early access (92% versus 40%, P < .0001). DISCUSSION X activity increased after the information blocking provision, partly due to conversation about early notification. Despite negative experiences with reports, most users preferred early access. Although the Cures Act is a positive step toward open access, work remains to improve patients' engagement with their radiology results.
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Affiliation(s)
- Michelle Kim
- NYU Langone Health, Department of Radiology, New York, New York.
| | | | - Ankur M Doshi
- Associate Professor and Associate Clinical Director, Radiology Informatics, NYU Langone Health, Department of Radiology, New York, New York
| | - Vinay Prabhu
- Clinical Assistant Professor, Associate Program Director, and Body MRI Fellowship, NYU Langone Health, Department of Radiology, New York, New York
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2
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Dutruel SP, Hentel KD, Hecht EM, Kadom N. Patient-Centered Radiology Communications: Engaging Patients as Partners. J Am Coll Radiol 2024; 21:7-18. [PMID: 37863150 DOI: 10.1016/j.jacr.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/22/2023]
Abstract
Patient-centered care is a model in which, by bringing the patient's perspective to the design and delivery of health care, we can better meet patients' needs, enhancing the quality of care. Patient-centered care requires finding ways to communicate effectively with a diverse patient population that has various levels of health literacy, cultural backgrounds, and unique needs and preferences. Moreover, multimedia resources have the potential to inform and educate patients promoting greater independence. In this review, we discuss the fundamentals of communication with the different modes used in radiology and the key elements of effective communication. Then, we highlight five opportunities along the continuum of care in the radiology practice in which we can improve communications to empower our patients and families and strengthen this partnership. Lastly, we discuss the importance on communication training of the workforce, optimizing and seamlessly integrating technology solutions into our workflows, and the need for patient feedback in the design and delivery of care.
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Affiliation(s)
- Silvina P Dutruel
- Department of Radiology, Weill Cornell Medical Center, New York, New York.
| | - Keith D Hentel
- Professor, Clinical Radiology, Executive Vice Chairman, Department of Radiology; Vice President, Weill Cornell Imaging at New York-Presbyterian, New York, New York
| | - Elizabeth M Hecht
- Vice Chair for Academic Affairs, Department of Radiology, Weill Cornell Medical Center, New York, New York. https://twitter.com/ehecht_md
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; Director of Quality, Department of Radiology, Children's Healthcare of Atlanta, Georgia; Interim Director of Quality, Department of Radiology, Emory Healthcare, Atlanta, Georgia; Chair, Practice and Performance Improvement Committee, ARRS; and Chair, Metrics Committee, ACR
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3
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Manik R, Carlos RC, Duszak R, Sadigh G. Costs Versus Quality in Imaging Examination Decisions. J Am Coll Radiol 2022; 19:450-459. [PMID: 35122720 DOI: 10.1016/j.jacr.2021.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Emerging price transparency tools allow consumers to access individualized out-of-pocket cost (OOPC) estimates, but many lack quality metrics. The aim of this study was to evaluate how potential patients weigh imaging OOPC versus measures of quality when selecting an imaging center for a hypothetical health condition (back pain). METHODS Surveying 1,310 Amazon Mechanical Turk volunteers, the authors evaluated how potential patients weigh MRI OOPC ($50 vs $400 vs unknown cost at the time of the examination, with billed OOPC responsibility varying between $50 and $3,500) versus service quality surrogates using three different quality indicators (examination results accuracy, physician recommendation of an imaging center on the basis of familiarity, and facility online star ratings) in their decisions when selecting a radiology center for imaging of two hypothetical clinical conditions (mild and severe back pain), using ranking-based conjoint analyses. RESULTS A total of 1,025 eligible respondents completed the survey. Respondents expressed higher preference for perceived quality over cost in hypothetical severe back pain scenarios, resulting in a relative importance of 65.8% (95% confidence interval [CI], 62.2%-69.4%) for improved imaging results accuracy from 87% to 96%, 63.9% (95% CI, 60.3%-67.5%) for provider recommendations of the facility, and 80.1% (95% CI, 74.2%-85.9%) for an increase in online review star ratings from 2.5 to 4.5 (out of 5) compared with an increased cost from $50 to $400. For mild back pain, there was no statistical difference in respondents' preference for perceived quality and cost. CONCLUSIONS Incorporating quality metrics into price transparency tools is important. Further research is needed to identify metrics that are most comparable and easily obtainable across imaging centers that remain important to patients.
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Affiliation(s)
- Ritika Manik
- Emory College of Arts and Sciences, Emory University, Atlanta, Georgia
| | - Ruth C Carlos
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Richard Duszak
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Gelareh Sadigh
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
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Kemp J, Short R, Bryant S, Sample L, Befera N. Patient-Friendly Radiology Reporting—Implementation and Outcomes. J Am Coll Radiol 2022; 19:377-383. [DOI: 10.1016/j.jacr.2021.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
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Kadom N, Fredericks N, Moore CL, Seidenwurm D, Shugarman S, Venkatesh A. Closing the Compliance Loop on Follow-Up Imaging Recommendations: Comparing Radiologists' and Administrators' Attitudes. Curr Probl Diagn Radiol 2021; 51:486-490. [PMID: 34565635 DOI: 10.1067/j.cpradiol.2021.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/23/2021] [Accepted: 08/04/2021] [Indexed: 01/28/2023]
Abstract
PURPOSE To compare non-physician healthcare professional and radiologists' survey responses regarding attitudes and current practices, policies, and procedures related to the follow-up of nonemergent actionable incidental findings (AIF). MATERIALS AND METHODS The American College of Radiology (ACR) developed a survey with input from a technical expert panel (TEP). Survey items were developed by TEP members, refined by an ACR market research expert, and were examined for face and construct validity. The survey was distributed among ACR membership and various medical professional organizations. Responses from non-physician responders and radiologists were analyzed and compared using descriptive statistics. RESULTS The analysis included 375 responses, 247 from radiologists and 128 from non-physicians. All respondent groups stated that radiology follow-up recommendations are evidence-based. Both respondent groups indicated that there is up to moderate risk associated with AIF follow-up. Both respondent groups similarly favored that the accountability for communicating AIF lies first with the ordering provider, followed by primary care providers, then the patient, and lastly an automated process that is managed by a staff member and/or the radiologist. All respondent groups indicated that tracking processes were more commonly funded by the healthcare system than through the radiology budget. CONCLUSION There is alignment between non-physicians and radiologists regarding the implementation of tracking systems that assure completion of radiology follow-up recommendations. Building tracking systems represents an opportunity for multi-disciplinary collaboration to address care transition communication and process gaps.
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Affiliation(s)
- Nadja Kadom
- Department of Radiology, Children's Healthcare of Atlanta, Atlanta, GA; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
| | | | - Christopher L Moore
- Section of Emergency Ultrasound, Emergency Ultrasound Fellowship, Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
| | | | | | - Arjun Venkatesh
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT
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Rother A, Niemann U, Hielscher T, Völzke H, Ittermann T, Spiliopoulou M. Assessing the difficulty of annotating medical data in crowdworking with help of experiments. PLoS One 2021; 16:e0254764. [PMID: 34324540 PMCID: PMC8321104 DOI: 10.1371/journal.pone.0254764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND As healthcare-related data proliferate, there is need to annotate them expertly for the purposes of personalized medicine. Crowdworking is an alternative to expensive expert labour. Annotation corresponds to diagnosis, so comparing unlabeled records to labeled ones seems more appropriate for crowdworkers without medical expertise. We modeled the comparison of a record to two other records as a triplet annotation task, and we conducted an experiment to investigate to what extend sensor-measured stress, task duration, uncertainty of the annotators and agreement among the annotators could predict annotation correctness. MATERIALS AND METHODS We conducted an annotation experiment on health data from a population-based study. The triplet annotation task was to decide whether an individual was more similar to a healthy one or to one with a given disorder. We used hepatic steatosis as example disorder, and described the individuals with 10 pre-selected characteristics related to this disorder. We recorded task duration, electro-dermal activity as stress indicator, and uncertainty as stated by the experiment participants (n = 29 non-experts and three experts) for 30 triplets. We built an Artificial Similarity-Based Annotator (ASBA) and compared its correctness and uncertainty to that of the experiment participants. RESULTS We found no correlation between correctness and either of stated uncertainty, stress and task duration. Annotator agreement has not been predictive either. Notably, for some tasks, annotators agreed unanimously on an incorrect annotation. When controlling for Triplet ID, we identified significant correlations, indicating that correctness, stress levels and annotation duration depend on the task itself. Average correctness among the experiment participants was slightly lower than achieved by ASBA. Triplet annotation turned to be similarly difficult for experts as for non-experts. CONCLUSION Our lab experiment indicates that the task of triplet annotation must be prepared cautiously if delegated to crowdworkers. Neither certainty nor agreement among annotators should be assumed to imply correct annotation, because annotators may misjudge difficult tasks as easy and agree on incorrect annotations. Further research is needed to improve visualizations for complex tasks, to judiciously decide how much information to provide, Out-of-the-lab experiments in crowdworker setting are needed to identify appropriate designs of a human-annotation task, and to assess under what circumstances non-human annotation should be preferred.
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Affiliation(s)
- Anne Rother
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Uli Niemann
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tommy Hielscher
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Myra Spiliopoulou
- Faculty of Computer Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
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He X, Zhang R, Alpert J, Zhou S, Adam TJ, Raisa A, Peng Y, Zhang H, Guo Y, Bian J. When text simplification is not enough: could a graph-based visualization facilitate consumers' comprehension of dietary supplement information? JAMIA Open 2021; 4:ooab026. [PMID: 33855274 PMCID: PMC8029346 DOI: 10.1093/jamiaopen/ooab026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Dietary supplements are widely used. However, dietary supplements are not always safe. For example, an estimated 23 000 emergency room visits every year in the United States were attributed to adverse events related to dietary supplement use. With the rapid development of the Internet, consumers usually seek health information including dietary supplement information online. To help consumers access quality online dietary supplement information, we have identified trustworthy dietary supplement information sources and built an evidence–based knowledge base of dietary supplement information—the integrated DIetary Supplement Knowledge base (iDISK) that integrates and standardizes dietary supplement related information across these different sources. However, as information in iDISK was collected from scientific sources, the complex medical jargon is a barrier for consumers’ comprehension. The objective of this study is to assess how different approaches to simplify and represent dietary supplement information from iDISK will affect lay consumers’ comprehension. Materials and Methods Using a crowdsourcing platform, we recruited participants to read dietary supplement information in 4 different representations from iDISK: (1) original text, (2) syntactic and lexical text simplification (TS), (3) manual TS, and (4) a graph–based visualization. We then assessed how the different simplification and representation strategies affected consumers’ comprehension of dietary supplement information in terms of accuracy and response time to a set of comprehension questions. Results With responses from 690 qualified participants, our experiments confirmed that the manual approach, as expected, had the best performance for both accuracy and response time to the comprehension questions, while the graph–based approach ranked the second outperforming other representations. In some cases, the graph–based representation outperformed the manual approach in terms of response time. Conclusions A hybrid approach that combines text and graph–based representations might be needed to accommodate consumers’ different information needs and information seeking behavior.
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Affiliation(s)
- Xing He
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Rui Zhang
- Department of Pharmaceutical Care & Health Systems, University of Minnesota, Minnesota, USA.,Institute for Health Informatics, University of Minnesota, Minnesota, USA
| | - Jordan Alpert
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, Florida, USA
| | - Sicheng Zhou
- Institute for Health Informatics, University of Minnesota, Minnesota, USA
| | - Terrence J Adam
- Department of Pharmaceutical Care & Health Systems, University of Minnesota, Minnesota, USA.,Institute for Health Informatics, University of Minnesota, Minnesota, USA
| | - Aantaki Raisa
- Department of Advertising, College of Journalism and Communications, University of Florida, Gainesville, Florida, USA
| | - Yifan Peng
- Department of Population Health Sciences, Weill Cornell Medicine, New York, USA
| | - Hansi Zhang
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, Florida, USA
| | - Yi Guo
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, Florida, USA.,Cancer Informatics Shared Resource, University of Florida Health Cancer Center, Gainesville, Florida, USA
| | - Jiang Bian
- Health Outcomes & Biomedical Informatics, University of Florida, Gainesville, Florida, USA.,Cancer Informatics Shared Resource, University of Florida Health Cancer Center, Gainesville, Florida, USA
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Potential Pitfalls of Online Crowdsourcing to Assess Patient Comprehension of Radiology Reports. AJR Am J Roentgenol 2020; 215:W65. [DOI: 10.2214/ajr.20.23249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Alarifi M, Patrick T, Jabour A, Wu M, Luo J. Full Radiology Report through Patient Web Portal: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103673. [PMID: 32456099 PMCID: PMC7277373 DOI: 10.3390/ijerph17103673] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study discusses the gap between the patient web portal and providing a full radiology report. A literature review was conducted to examine radiologists, physicians, and patients’ opinions and preferences of providing patients with online access radiology reports. The databases searched were Pubmed and Google Scholar and the initial search included 927 studies. After review, 47 studies were included in the study. We identified several themes, including patients’ understanding of radiology reports and radiological images, as well as the need for decreasing the turnaround time for reports availability. The existing radiology reports written for physicians are not suited for patients. Further studies are needed to guide and inform the design of patient friendly radiology reports. One of the ways that can be used to fill the gap between patients and radiology reports is using social media sites.
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Affiliation(s)
- Mohammad Alarifi
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
- College of Medical Applied Sciences, King Saud University, Riyadh, SA 11451, USA
| | - Timothy Patrick
- College of Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Abdulrahman Jabour
- Health Informatics Department, Faculty of Public Health and Tropical Medicine at Jazan University, Jazan, SA 45142, USA;
| | - Min Wu
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
| | - Jake Luo
- College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA; (M.A.); (M.W.)
- Correspondence:
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