EHR integration gives patients better access to images

2020 08 11 21 41 1875 Computer Future Hologram 400

Integrating a dedicated patient image portal with the portal for an electronic health record (EHR) can significantly increase the number of patients who access their medical images, according to a case study published online January 23 in the Journal of the American College of Radiology.

Dr. Amy Ellenbogen and colleagues at the University of Virginia Novant Health System shared how nearly sevenfold more patients began accessing their images and reports following the integration of the institution's patient imaging portal with its EHR patient portal.

The University of Virginia had offered an imaging patient portal (CareVue, Carestream Health, and then Philips Healthcare) since 2013. A few years ago, they requested that the portal be integrated with the MyChart EHR patient portal (Epic Systems).

After the portal integration was completed and launched for patients in September 2019, existing patient accounts for the dedicated imaging portal were deactivated. With the new process, patients who are logged into the EHR patient portal can click on links in the radiology report to view the images.

"The patient experience was streamlined such that the two portals effectively behaved like one, and some users may not have observed that separate applications were involved," Ellenbogen et al wrote.

Although the integration process took about three years, implementation at a similar site should take just months now that this capability has been developed, according to the authors.

To assess the effect of the portal integration, the researchers tabulated the number of unique patients who had viewed their images in the five months prior to the integration and in the five months afterward.

Number of users accessing their images before and after imaging portal integration into the EHR patient portal
  On patient image portal (for 5 months before integration with EHR) Integrated imaging/EHR patient portal (for 5 months after integration)
Unique patients 1,925 13,202
*The difference was statistically significant (p < 0.001).

"The integration was the primary driver of the improvement in patient engagement in their images," the authors wrote. "Furthermore, this mechanism goes beyond the delivery of images and traditional plain text-only radiology reports, by also distributing interactive multimedia reports directly to patients using their pre-existing EHR portal accounts."

The researchers noted that patients may find interactive multimedia reports easier to understand than traditional plain-text radiology reports.

"With many radiology malpractice lawsuits related to communication errors, supplying patients with direct access to their imaging studies and reports could serve to improve communication and perhaps, decrease unnecessary litigation," they wrote.

The 21st Century Cures Act also mandates that patients have access to their patient records -- including imaging results -- without delay.

"EHR patient portals are a convenient way for patients to access their imaging results, but historically these have been limited to plain text-only reports," the authors wrote. "The vast majority of U.S. institutions rely on CDs, despite associated logistical issues and costs, to share medical images with patients and providers."

The researchers acknowledged a number of limitations to their results, including the lack of a survey to assess whether their improved access to reports enhanced patient satisfaction or understanding. They also did not calculate how often patients clicked on the interactive elements of the radiology reports.

Furthermore, "Our institution should be less reliant on CDs to distribute images to patients, but we did not evaluate for actual time or cost savings," they wrote.

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