The document discusses the transformation of communication for radiologists through new online tools and social media, emphasizing accessibility, interconnectivity, and enhanced patient engagement. It outlines the various reasons radiologists use social media, the concerns regarding privacy and legislation, and highlights the importance of secure messaging applications. Furthermore, it advocates for patient-centered practices and the potential benefits of open notes to improve patient care and communication between clinicians and patients.

1. IT changes communication
for radiologists
Erik R. Ranschaert
E. R. Ranschaert, EUSOMIIValencia, 2016

2. Topics
• Online communication in health care
– What is available?
– What should we use?
– How should we use it?
• Accessibility of reports through i-Portals
E. R. Ranschaert, EUSOMIIValencia, 2016

3. New communication tools
Society
• Unlimited interconnectivity
• Boundless ability to share
knowledge and expertise
• Viral transit of information
Healthcare
• New ways of communicating
with peers and patients,
eliminating geographical
distance and thresholds
• Greater patient engagement,
new patient demands
E. R. Ranschaert, EUSOMIIValencia, 2016

4. Patients andTwitter
E. R. Ranschaert, EUSOMIIValencia, 2016

5. E. R. Ranschaert, EUSOMIIValencia, 2016

6. Radiologists andTwitter
E. R. Ranschaert, EUSOMIIValencia, 2016

7. For what reason(s) are you using Social Media professionally? Total %
To stay informed about the latest news & developments in radiology 65
To communicate with colleagues about radiological topics (national & international) 49
To share and discuss interesting or difficult cases/images with colleagues 34
To increase my influence and promote my ideas/vision among radiologists 29
To make our profession more visible for patients 27
To make my expertise and knowledge available for teaching purposes 25
To market our team and services 19
To become more "social" with both patients and clinicians 18
To enable people and patients to communicate with radiologists 17
To inform patients about the examinations they will undergo 7
To get feedback from patients (both positive and negative) 6
To discuss radiological images with patients 4
To apply for a job or to be visible for recruiters 3
Reasons for using SoMe
E. R. Ranschaert, EUSOMIIValencia, 2016
RANSOM survey 2015

8. Top concerns of radiologists about SoMe
E. R. Ranschaert, EUSOMIIValencia, 2016
Insufficient legislation, guidelines and policies for SoMe in healthcare 75%
Risk for privacy of the patients 39%
Risk for privacy of radiologists 39%
Insufficient knowledge about social media among radiologists 37%
Distraction from clinical activities 28%
Deprivation from real social contact with others 18%
Danger of negative comments on our practice 13%
RANSOM-survey

9. The new social media
• Private messaging
(end-to-end social networking)
• “Dark social channels”
– E-mail, SMS
– Messaging apps
– Private / secure browsing
• Social sharing of links: 70% of all
online referrals come from dark
social channels
http://www.adrenalinmedia.com.au/blog/march-2016/are-
messaging-apps-the-new-social-media

10. Messaging Apps
E. R. Ranschaert, EUSOMIIValencia, 2016

11. WhatsApp from patient
E. R. Ranschaert, EUSOMIIValencia, 2016

12. WhatsApp from radiologist
• “I got this picture of an angiogram at 11 PM
viaWhatsApp from another radiologist.The
patient was in coma, almost dead.”
• “The colleague wanted to know what this
structure on the angiogram is. I’m specialised
in cerebral stroke and could see that it was a
thrombosis of the basilar artery with a rare
anatomic variant.”
• “I could explain the colleague how to deal
with this abnormality; the patient could be
treated quickly, woke up after treatment and
could go home.”
Croonen H.Veilig whatsappen een must voor dokters.
Med Contact 2015(48):2312-5. E. R. Ranschaert, EUSOMIIValencia, 2016

13. WhatsApp image exchange
Private Cloud
MRI scanner
Radiologist
PACS
server
InstitutionA
Community Hospital
Institution B
Specialty Hospital
Radiologist
Institution C
Community Hospital
Radiologist
Public
Cloud
Mobile device
physician/radiologist
E. R. Ranschaert, EUSOMIIValencia, 2016
Encryption is provided, but:
Where is the server located?
What happens with images on the mobile devices?

14. WhatsApp in Netherlands
• Study at Albert Schweitzer hospital:
– 40% of doctors useWhatsApp for clinical purposes
– In 33% name of patient is mentioned
– In 62% picture of patient is included
• Although SoMe are used for benefit of patient
care, most specialists are not aware of the lack of
privacy
Source: Heleen Croonen; Medisch Contact Nr. 48, 26 november 2015, p 2312-2315
E. R. Ranschaert, EUSOMIIValencia, 2016

15. Newspapers Feb. 24th
• Dutch DPA stands for the
fundamental right to the
protection of personal data
• “WhatsApp does not meet the
standards for sharing medical
data.”
• The individual doctor and/or
institution may receive a fine for
breaching protection of personal
data
• Medical doctors should find
alternative solutions
http://linkis.com/medischcontact.nl/oRWkJ
E. R. Ranschaert, EUSOMIIValencia, 2016

16. Dedicated messaging apps
E. R. Ranschaert, EUSOMIIValencia, 2016

17. Example
E. R. Ranschaert, EUSOMIIValencia, 2016
• End-to-end encryption
• Security of data at rest
– PIN-code access
– Remote wiping of data from
mobile device
– 30-day auto deletion of data from
mobile device
– Immediate deletion of servers
after arrival
– Anonymisation tool
– Professional profile of each user

18. EU directive 2016
• 1 single regulation for EU replacing the current
patchwork of national laws
• Cloud provider (data processor) must protect
information it handles and stores on behalf of
data controller
• Data controllers have to demonstrate that they have
taken appropriate security measures to protect
personal data
E. R. Ranschaert, EUSOMIIValencia, 2016
Data subject
Data controller
Data processor

19. Privacy legislation
EU directive 2016
Professional standards
(ESR?)
Organisational policy
(Hospital)
Individual best practices
(Physician, radiologist)
Kendra Gagnon, and Carla Sabus PHYS THER 2015;95:406-
414
Four-sphere concept

20. Secure messaging
• Goal:
– to enable patients and their providers (clinicians
and their supporters) to communicate
electronically, privately and securely.
http://searchhealthit.techtarget.com/feature/SMS-doesnt-translate-to-secure-messaging-in-healthcare

21. Secure messaging: why?
• Possible applications for patients:
– making (and confirming) medical appointments
– asking medical questions
– discuss treatment options
– send medical device readings to a care provider
• blood pressure, X-ray result etc.
E. R. Ranschaert, EUSOMIIValencia, 2016

22. KPN
E. R. Ranschaert, EUSOMIIValencia, 2016
“Zorgmessenger”

23. i-Portals
• Web portals: online tools providing patients direct & secure access
to personal HR.
• Some are offering patients access to radiologic test results.
• Research has demonstrated patient dissatisfaction because of
– delays in receiving test results
– lack of clarity with results findings.
• Growing patient desire to view their full radiology reports online .
• Desire influenced by socioeconomic factors.
E. R. Ranschaert, EUSOMIIValencia, 2016

24. OpenNotes
• Created on the notion that information between
patients & doctors should be equal and
transparent
• 10.000.000 patients can read their medical notes
online
• Study of doctors and patients in 1-year pilot
program

26. Research results
Up to 92% of patients in the OpenNotes study opened their notes
More than 60% of patients reported doing better with taking medications as
prescribed because of open notes
More than 77% of patients reported that open notes helped them feel more in
control of their care
More than 86% of patients agreed that open notes would be an important factor in
choosing a future doctor or health plan
Fewer than 8% of doctors reported taking more time to address patients’ questions
outside of visits
Fewer than 20% of doctors reported taking more time writing notes
99% of patients wanted open notes to continue

27. Content of reports
• How much detail is in note is up to individual HC
provider
• Clinicians try to use terms that are still
understandable to patients
• “For me the most difficult thing was having to be
careful about tone and phrasing of the notes
knowing the patient would be reading them.”

28. Acad Radiol 2016
E. R. Ranschaert, EUSOMIIValencia, 2016

29. Shift to patient-centered radiology
E. R. Ranschaert, EUSOMIIValencia, 2016

30. OpenNotes is like a new medicine
• Its goal is to help people manage health and
illness more effectively
• It can have side effects and may hurt some
patients
• Clinicians and patients will need to learn how
to use it well

31. Summary
• It’s important to understand the concept of social networking
• SoMe can be used by radiologists to enhance collaboration,
networking, education/training and to keep up with information
• Health professionals need some guidance to enhance use and
avoid pitfalls in their use of SoMe and to uphold their professional
values.
• Appropriate use of new communication tools should result in
better patient care.
E. R. Ranschaert, EUSOMIIValencia, 2016