The document discusses patient portals and access to radiology reports. It provides perspectives from studies that found patients who accessed their medical information through portals had more accurate understanding and were better prepared for appointments. Both patients and referring physicians generally had positive experiences with portals and access to reports. However, doctors were more reluctant about automatically releasing certain types of imaging reports like CTs and MRIs. The document also examines usage rates of portals and challenges with implementing multimedia tools and sharing medical images with patients.

1. Patient Portals
Multimedia Reports
Fundación Santa Fe de Bogotá | 2017
Thiago Julio, MD

2. Radiologist
Fellowships: Oncology / Intervention
Specializations: Clinical Research / Health Informatics
Head of Informatics: Hospital Sirio-Libanes
Co-founder and director: IHE Brazil
Informatics Committee: Brazilian College of Radiology
Scientific Committee: RSNA / SIIM (Informatics)
Angel investor / Board Member: eHealth Startups
Fundación Santa Fe de Bogotá | 2017

5. LeitosOperacionais
(611)
Leitos Unidade Crítica Internações/mês
Salas Cirúrgicas (41) Procedimentos Cirúrgicos / mês
Atendimentos/mês
Pronto-Atendimento
Exames/mês
17 mil Pacientes/mês
Colaboradores Médicos

6. 1 high complexity hospital
1 day hospital
3 oncologic centers
4 diagnostic centers
1 academic & research center
2 public hospitals
1 public diagnostic centers

7. • 30+ US
• 8 CT
• 10 MR
• 15+ CR
• 5 MG
Radiology
• 4 DX
• 3 PET-CT
• 2 NM
• 160+ radiologists
• 30+ residents/fellows

8. PACS
3.8 million studies
630k studies/year (2016)

15. “The more people spend for health care out-of-pocket,
the higher their expectations of customer service.”
Kaveh Safavi, global head of health for Accenture

16. enhancing the patient
experience
reducing the cost
of care
improving population
health

21. Consumerism vs. Paternalism
Fundación Santa Fe de Bogotá | 2017

22. Clinical Judgment
Fundación Santa Fe de Bogotá | 2017
Personalized/Precision Medicine
Evidence Based Medicine

23. Information Assimetry
Fundación Santa Fe de Bogotá | 2017

25. +
RSNA 2012
Honorary Lecture
Meaningful IT Innovation to Support the Radiology
Value Proposition
Paul J. Chang, MD

27. @tgoetz

52. Should patients read their reports?
Despite concerns, studies measuring the impact of patient
portals have not found an increase in consumer
misconceptions about health information.
In contrast, patients who reviewed their data via a portal
reported that it led them to more accurate information
and better prepared them for upcoming clinical visits,
as well as made them more able to cope with the
anxiety associated with diagnoses when they receive
information on disease progression and treatment.
Arnold CW, Mcnamara M, El-saden S, Chen S, Taira RK, Bui AA. Imaging informatics for consumer health:
towards a radiology patient portal. J Am Med Inform Assoc. 2013;20(6):1028-36.

53. Should patients read their reports?
Increased access to information for cancer patients,
including their medical records, has been shown to
increase satisfaction with treatment choices, increase
confidence in care providers, and improve adherence to
medical advice.
Portal access also allows the consumer to consolidate
information that has historically been dispersed across
sources, an important concern in medical imaging.
Arnold CW, Mcnamara M, El-saden S, Chen S, Taira RK, Bui AA. Imaging informatics for consumer health:
towards a radiology patient portal. J Am Med Inform Assoc. 2013;20(6):1028-36.

54. Johnson AJ, Easterling D, Nelson R, Chen MY, Frankel RM. Access to radiologic reports via a patient portal:
clinical simulations to investigate patient preferences. J Am Coll Radiol. 2012;9(4):256-63.
Do patients want to read their reports?

55. Johnson AJ, Easterling D, Nelson R, Chen MY, Frankel RM. Access to radiologic reports via a patient portal:
clinical simulations to investigate patient preferences. J Am Coll Radiol. 2012;9(4):256-63.
Do patients want to read their reports?

56. Do patients want to read their reports?
Johnson AJ, Easterling D, Nelson R, Chen MY, Frankel RM. Access to radiologic reports via a patient portal:
clinical simulations to investigate patient preferences. J Am Coll Radiol. 2012;9(4):256-63.

57. • 74% (377) of patients found reports easy to access
• 88% (446) reported that the ability to do so was
important
• 49% (250) of patients were contacted by their referring
physician before report release
• 25% (156) contacted their physician for more
information after viewing a report
Henshaw D, Okawa G, Ching K, Garrido T, Qian H, Tsai J. Access to Radiology Reports via an Online
Patient Portal: Experiences of Referring Physicians and Patients. J Am Coll Radiol. 2015;12(6):582-6.e1.
Do patients like to access their reports?

58. Do patients like to access their reports?
Henshaw D, Okawa G, Ching K, Garrido T, Qian H, Tsai J. Access to Radiology Reports via an Online
Patient Portal: Experiences of Referring Physicians and Patients. J Am Coll Radiol. 2015;12(6):582-6.e1.
It was a positive experience
“My doctor placed a message in my e-mail that was attached to the report, which is great.”
“It’s helpful and much more efficient to see it online.”
“I was glad to get my results so quickly and easily.”
“I am very pleased with the radiology and blood test reports.”
They wanted access to more reports, and to images
“My biggest issue is that some reports have never been released to me while others have.”
“I cannot find all my x-ray results. I assume there are certain ones that do not get released to
patients.”
“I have had an elbow x-ray, chest x-ray, CT scan, etc. Only report showing is for elbow—very
insufficient reporting on those tests.”
“I would have liked to see the images.”

59. Do doctors like that patients access reports?
Henshaw D, Okawa G, Ching K, Garrido T, Qian H, Tsai J. Access to Radiology Reports via an Online
Patient Portal: Experiences of Referring Physicians and Patients. J Am Coll Radiol. 2015;12(6):582-6.e1.
• 88% (42) found that releasing reports to patients was useful
• Auto-release of x-ray reports, with a 1-week delay, was
preferred by 58% (28)
• they were more reluctant to auto-release CT and MRI reports
• 86% (41) of referring physicians reported that follow-up
emails, telephone calls, and office visits were unchanged or
had decreased

60. Do doctors like that patients access reports?
Henshaw D, Okawa G, Ching K, Garrido T, Qian H, Tsai J. Access to Radiology Reports via an Online
Patient Portal: Experiences of Referring Physicians and Patients. J Am Coll Radiol. 2015;12(6):582-6.e1.
It is helpful to explain results, so releasing reports is beneficial to patients and physicians
“Making sure that the reports are easy to read, in layman’s terms as much as possible, could
decrease the amount of call backs and patient concerns. It’s helpful and much more efficient to see
it online.”
“Many radiology reports have benign but abnormal findings mentioned. I recommend we have
smart phrases (standardized text entries) to help explain common findings that are clinically
benign but possibly alarming to the patient. This will help educate clinicians as well.”
“When I press the kp.org release button from the results tab, the results are released. I usually
(add) some explanatory comments.”
“I have been attaching a short note with the released results. I think that this really reduces the
follow up email and calls.”
They had mixed feelings about auto-release of radiology reports

61. Gheorghiu B, Hagens S. Use and Maturity of Electronic Patient Portals. Stud Health Technol Inform. 2017;234:136-141.
Do patients access their portals?

62. Gheorghiu B, Hagens S. Use and Maturity of Electronic Patient Portals. Stud Health Technol Inform. 2017;234:136-141.
Do patients access their portals?

63. Tavares J, Oliveira T. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey. J
Med Internet Res. 2016;18(3):e49.

64. Tavares J, Oliveira T. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey. J
Med Internet Res. 2016;18(3):e49.

65. Acúmulo de gordura no fígado,
possivelmente relacionado à dieta
RISCO: infarto e derrame (moderado) cirrose (baixo)
clique aqui para saber mais
TO DO: dosar níveis de colesterol e TGC
Nódulo BENIGNO no fígado, muito comum
RISCO: complicações são raríssimas (hemorragia,
malignização)
TO DO: vigilância clique aqui para saber mais

66. Arnold CW, Mcnamara M, El-saden S, Chen S, Taira RK, Bui AA. Imaging informatics for consumer health: towards a radiology patient
portal. J Am Med Inform Assoc. 2013;20(6):1028-36.

68. @jnd1er

70. • Efficient
– how quickly?
– how many clicks?
• Intuitive
– is it easy to get from one place to another?
– is it easy to figure out information?
• Accessible

76. dashboards

77. body maps

84. Stages
Implementation
Adoption
Quality metrics
ROI

85. Multimedia tools adoption
130k studies
90k key images (70%)
5.5k bookmarks (4%)

86. Challenges
Who owns the images?
Who gets the results first?
Are doctors allowed to share patients tests?
Should we stop printing?
Critical results
Terminology
Linked studies
Grace period
lessons learned

87. Gracias!
@thiago37
thiago.julio@hsl.org.br