Pointing the Way
Radiology-specific resources empower patients in the digital age.
Plug in the terms "Radiology," "Patient," and "Resources" into a search engine, and you'll be provided with more than 22 million results. Overwhelming? Yes — especially for patients seeking basic answers about a basic radiological exam or procedure.
The Internet provides access to millions of medical sites, but not all are credible. How can radiologists and referring physicians guide their patients to the best resources possible?
Lost in Translation
The public needs trustworthy information about radiology. Why? Because patients are confused — not just about radiological exams but also about the radiologist's role. According to findings presented at RSNA 2012, only one-half of patients understand that radiologists are, in fact, physicians.
Elliot K. Fishman, MD, FACR, professor of radiology, surgery, and oncology at the Johns Hopkins University School of Medicine, director of diagnostic imaging and body CT at the Johns Hopkins Hospital in Baltimore, and co-chair of the RSNA-ACR Public Information Website Committee, believes these misunderstandings are deeply rooted. "As a kid, you never saw a television show about radiologists," he explains. "Even in shows like ER, the emergency room doctors performed the radiology studies."
Coupled with this lack of attention is the fact that radiology is an ever-changing specialty. "Go back 30 years and everyone knew what an X-ray was," Fishman adds. "Now we've got CT and MRI and angiography and PET. We've been blessed with new technology that does so much for patient care, but we've never been able to get that information to the general public."
Filling these holes in public understanding is critical, according to Christoph Wald, MD, PhD, executive vice chair of radiology at the Lahey Clinic, professor of radiology at Tufts University Medical School in Burlington, Mass., and co-chair of the RSNA-ACR Public Information Website Committee. "Patients like to be given information because it empowers them to make better, informed decisions," he says. "Not all medical conditions are black and white, and it's not always clear what information is correct, complete, and up to date."
Additionally, patients receive tangible benefits from reviewing radiology information before their exams and procedures. "They prepare mentally for what is to come," explains Wald. "They also come in with more pointed questions for their primary-care physician or radiologist."
In his research, Joseph R. Steele, MD, MMM, deputy division head of operations in diagnostic imaging at MD Anderson Cancer Center in Houston, found that communication was a primary concern for radiology patients rating their overall experience. "The information given to patients creates expectations, which then drive their experience," says Steele, co-author of the RSNA 2012 poster "A Standard Method of Measure the Quality of Care from the Patient's Perspective." This means that a patient who has no idea what to expect from an MRI may be displeased by details he or she might have already known if resources were made available — such as the procedure's length and other variables.
Steele urges ACR members to remember that different populations and individuals may prefer either web or print resources. "Factors like age determine the most effective method of communicating. Essentially, we need to offer all types of resources to our patients," he adds.
Nonetheless, Fishman acknowledges that these days, "the quickest information source is the Web." And online resources provide an opportunity to clarify radiology's role in patient care, explain a procedure's benefits, and manage patient expectations. Fishman says, "Medicine is one of the top things people search for. But a lot of websites are incorrect. They don't give details that patients need."
That's why the RSNA-ACR Public Information Website Committee created www.RadiologyInfo.org in 1999, enhancing the resource with periodic updates. The site was "established to inform and educate the public about radiological procedures and the role of radiologists," according to its mission statement.
Choosing where to look for trustworthy radiology information online is like choosing an accountant, says Wald. "You don't go to any old advisor," he explains. "You go to someone you trust — someone in your family or someone who knows you well."
The User Experience
Meeting the desire for honest and trustworthy information was a primary goal of the RSNA-ACR Public Information Website Committee when it created www.RadiologyInfo.org All text is crafted by medical writers, reviewed by physician experts, and approved by section editors and the committee co-chairs.
Making sure the information is comprehensible to patients is a priority. To Fishman, this means writing explanations in layman's terms and also supplementing them with additional Web features. He explains, "It's one thing for me to write two paragraphs about CT, but it can still be difficult for patients to read and understand." As a result, www.RadiologyInfo.org includes video, sound, and images. "We're really taking advantage of the Web and the ability to communicate with people," says Fishman, who emphasizes creating a meaningful user experience for patients.
This approach has been largely successful: www.RadiologyInfo.org receives about 700,000 hits per month, adding up to approximately 8 million per year. But to its founding organizations and co-chairs, there is more work to be done. "If technology changes, we need to make sure we adapt too," says Fishman. "We need to be cognizant of the changing world and how people get information, and we need to be ahead of the curve." That's why the site recently launched as an app at RSNA 2012.
Despite a huge number of hits, promoting www.RadiologyInfo.org and other College-approved resources requires the commitment of ACR members. According to Wald, "First, don't assume your colleagues know about the site, because many do not." Spread the word — mention the URL at a staff meeting or send out an all-staff e-mail.
Second, since referring physicians are often the ones fielding patient questions, point them to the correct resources. "They will be extremely grateful," says Wald. Steele emphasizes that it's also important to keep non-medical individuals, such as those in scheduling or administration, updated about where they can direct patients.
Third, put a link to particular sites on your patient portal — "a prime piece of real estate," according to Wald. Steele says MD Anderson utilizes its patient portal to ensure information received by patients has been vetted by experts in the department. Fishman, too, suggests adding the URLs of resources like www.RadiologyInfo.org to prescription pads.
In the end, both Wald and Fishman believe nothing can replace face-to-face contact. "We can put everything we want on the Web, but sometimes we need to pick up the phone or walk into the clinic and speak to patients," says Fishman. "That's why we're here — to answer questions and make patients feel more comfortable."
By Alyssa Martino