Empowering Patients

As patient interaction increases, how can radiologists improve communication to ensure appropriate care and maximize value?

Patients

 

August 2015

As you may have noticed in your practice, patients today increasingly expect to understand and make decisions about the health care they are receiving.

Increased access to information, higher insurance deductibles, and limited financial resources have combined to motivate and empower patients to get involved in their care decisions. And while patients have access to more information than ever before, that doesn’t mean they don’t rely on their physicians to provide context and guidance as they navigate the health care system. The Patient Advocate Foundation shares insights into the radiologist–patient relationship today and where to go from here.

Identify Communication Barriers

Patient participation is a focus of heath care reform and encourages increased communication between providers and patients. Patients today want to know who is providing their care, understand the factors influencing their care decisions, and receive context in which to place their results. Given the change in the relationship between the radiologist and patient, it’s integral that referring physicians stay engaged as part of the communication around radiology results. This three-way dialog is key to ensuring patients are empowered to understand their radiology results.

If you have the opportunity to directly share imaging results with patients, it is important to remind the patient to follow up with their physician for information on how to place these results in the context of their diagnosis and medical history. Not all patients understand that radiologists focus on consultative diagnosis, while referring physicians generally coordinate treatment.

For example, if the patient asks for information beyond what the radiologist is comfortable providing, the radiologist can respond with “I would need more knowledge of your medical record, but your referring physician should be able to answer your question more fully.” This strategy allows the radiologist to communicate patient results without offering medical advice that is not coordinated with the patient’s primary physician. This kind of answer supports good care and collegial collaboration that benefits the patient.

Work as a Team

One of the best things a radiologist can do for patients happens before a study is even ordered. Referring physicians and radiologists are allies in providing quality patient care, and the success of this relationship can significantly impact patients. Radiologists are a great resource for other physicians as they order imaging, whether that means championing clinical decision support tools like ACR Select® or being available to answer questions about which study is appropriate for a given clinical scenario.

Initiatives like Choosing Wisely, Image Wisely®, and Image Gently® are designed to increase physician–patient communication and outline what constitutes appropriate treatment. Helping patients avoid the physical, mental, and financial risks associated with unnecessary imaging and treatment by educating their peers is a key responsibility of the radiologist and adds value throughout the health system.

Radiologists can also assist their referring physicians in communicating with patients around imaging by informing their colleagues about available patient-friendly material. This content can be provided online and within the patient portal for convenient patient reference. Sharing easy-to-understand multimedia resources can help bridge the information gap and improve health literacy, ensuring a positive experience for both patients and providers.

Address Patient Concerns

Each case that comes across your screen represents an individual with a different set of questions, concerns, and experiences. Here are a few of the most common concerns patients may raise (and some advice on responding appropriately and empathetically).

“I’m afraid the costs will be too high for my scan.” Patient concerns are frequently rooted in the financial costs associated with procedures and the medical repercussions of forgoing the test.

The reality is that many patients are shouldering a larger portion of their health care costs and in extreme cases may be choosing between undergoing a study and providing basic needs to their families. Physicians can remind patients to connect with their insurance company early about copayments or prior-authorization paperwork, while also alerting them to available in-house charitable programs, payment plans, and additional resources to help offset costs.

“Is this test really necessary?” Radiation exposure has received increased attention in the media in recent years, heightening patient awareness of the risks of unnecessary imaging procedures. Pair this with concerns about the appropriateness of some medical testing, and radiologists are likely to be fielding more questions from patients about the safety of a recommended scan.

Respond to such questions in a non-defensive manner, outlining the benefits of the procedure and giving an accurate representation of the risks in comparison. By communicating respectfully in language the patient can understand, you help patients make informed decisions about their care.

“I want the most advanced test from the very beginning.” Sometimes patients can be quick to insist that their situation warrants an MRI, CT, or other procedure without truly understanding the differences between the exams or which is most appropriate for their case. In these situations, it is important for the referring physician or radiologist to focus on educating the patient on the medical factors that influenced the imaging recommendation. If there are options to consider, it is important that the patient be given information in plain language about each alternative, including correlating risk factors and potential outcomes, so they can act as their own advocate and be part of the decision team for the care they receive. Communicating potential insurance coverage processes and paperwork can also be important at this stage.

This is also an opportunity to employ clinical decision support tools to ensure you and your referring colleagues are following best practices for ordering exams — and communicating this to the patient and insurance company. Patients seeking advanced imaging are searching for information, which is exactly what clinical decision support provides. Referring to the evidence-backed guidance that influences your decisions will prove helpful as you communicate with your patients.

Bring It Together

As the health care system changes and patients take more ownership of their medical decisions, radiologists are ideally positioned to act as a resource for both patients and referring physicians. By optimizing their integral role in diagnosis, they can do just that.


Bringing Accurate Information to Your Patients

The following are trustworthy resources for patients to learn more about medical imaging. Share this information with both referring physicians and patients in order to engage patients in their own health care decisions and reinforce the value of medical imaging.
Radiologyinfo.org
This website explains what patients can expect when undergoing various procedures and when being screened for a range of conditions. Information is avaiable in both English and Spanish.
Image Wisely
Refer your patients here for information about radiation safety when undergoing common imaging exams.
Image Gently
A host of resources on appropriate imaging for children. Refer concerned parents to this website for frequently asked questions about radiation dose and educational materials related to the most common pediatric imaging procedures.
Breast density information brochure
Consider printing out some brochures to have on hand for patients who prefer a hard copy.


Meet the Patient Advocate Foundation

The Patient Advocate Foundation provides real-time help for patients facing critical illness as they encounter barriers in their health care. The foundation delivers tangible assistance through personalized case management services, financial support towards medication copayments, and the connection to vital community resources, all at no cost to the patient or their caregiver. 


By Alan Balch, PhD, chief executive officer at the Patient Advocate Foundation

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