“Patients who want to talk to a radiologist still have access to us, but we found that patients who had a referring clinician were more likely to comply with follow-up recommendations,” Whitney observes. He and his colleagues found that it was important to keep the lines of communication open with referring physicians. Most physicians also prefer to talk directly with their patients since they know their health history and can provide a more familiar and structured environment. “We can tell someone that an annual lung cancer screening is recommended for heavy smokers, but if the patient has a limited life expectancy from some other disease, we may not know that,” explains Whitney. “Our experience has confirmed the importance of teaming with the patient’s primary clinician to triage who really needs screening and to ensure appropriate follow up.”
When the referring physician is involved in the patient’s management, it becomes the responsibility of the radiologist to educate the referring physician about emerging changes in lung cancer screening recommendations. “We now insert a statement about which important medical organizations and government advisory committees are recommending lung cancer screening at the bottom of our reports (click here to see an example) to the referring physician,” Whitney states. “Many physicians don’t actually know what and how widespread the screening recommendations are, so they are generally surprised. With the information in our report, they then know these aren’t just guidelines radiologists are pushing; they are widely accepted in the medical establishment.” Whitney has observed that many clinicians are still confused by current guidelines, so radiologists play a crucial role in keeping them aware of the most recent screening and follow-up recommendations from both national organizations and government advisory committees.
In addition to offering same-day scan results and providing educational assistance to referring clinicians, Hoag has implemented two new technologies that have helped referring physicians review scans more conveniently and receive results faster: server-side rendering and encrypted secure text messaging. With server-side rendering, clinicians are able to skip the time-intensive process of downloading images through their off-site web browser and directly access their patient’s images in the PACS server. This can be done through any available device, including an iPad or iPhone, all through a secure portal.
With secure encrypted text messaging, the radiologists can text summarized results in a secure text format and receive notification when the text has been read. The text message lets radiologists transmit private patient information to physicians without violating HIPAA privacy laws. Many clinicians, Whitney observes, prefer receiving these important notifications via text, since a text message can be less intrusive.
“When I send a report to the ER physician, I know whether my text about a result has been read or not, and know whether I need to pick up the phone and call,” observes Whitney. “Even if a physician has a final written report in their office in half an hour, the time it takes for a physician to look at those reports may vary,” he points out. “It could be at the end of the day, or not until the patient returns to the office for their next appointment. It is still very important to call for those significant results.”