Paving the Way: Patient Access to Radiology Results

A recent article in DiagnosticImaging asked the question "should patients have access to images and reports?" The answer, according to Zwanger-Pesiri Radiology's CEO and Medical Director, Steven L. Mendelsohn, MD, is a resounding "yes!"

Zwanger-Pesiri Radiology was an early adopter of the patient portal idea. ZPR's portal, launched almost two years ago, allows patients to access their exam results via their own computer. Patients can now view and print their reports. But patient portals have been met with some concern by doctors who worry that patients will get results online rather than from their referring physician. Mendelsohn, quoted in DiagnosticImaging, laid those fears to rest. "It's such an overwhelming benefit to give patients the results. I cannot think of a practical downside, whether the results are good or bad," he said. Plus, he added that an extra set of eyes is always a good thing. "The patients may pick up on stuff in their report that the referring doctor didn't notice," said Mendelsohn.

According to Mendelsohn, some referring physicians have even called to thank him for providing the reports online to patients. It ensures that patients get their results without delay, and speeds the whole process. Best of all, it gives patients a feeling of control, and the ability to be involved in their own health care.

Patients have greeted the portal with great enthusiasm. "Thank you for instituting the use of the patient portal," wrote one patient. "It is so wonderful to be able to access a record of all procedures and reports, appointments, etc. So much better than asking doctors for copies or to fax results. Having this kind of record at our fingertips is invaluable on so many levels. I will be sure to have all procedures done at Zwanger-Pesiri in the future."

Have you tried Zwanger-Pesiri's patient portal yet?

Zwanger-Periri Radiology is the leading Long Island provider of diagnostic imaging, with 12 offices throughout Nassau and Suffolk counties.

it’s such an overwhelming benefit to give patients the results. I cannot think of a practical downside, whether the results are good or bad, - See more at: http://www.diagnosticimaging.com/pacs-and-informatics/patient-portals-should-patients-have-access-images-reports?GUID=D19C12D8-83B1-4869-969F-926B0ADB9D75&rememberme=1&ts=15112013#sthash.jmseAhuq.4PQSCKgQ.dpuf

it’s such an overwhelming benefit to give patients the results. I cannot think of a practical downside, whether the results are good or bad, - See more at: http://www.diagnosticimaging.com/pacs-and-informatics/patient-portals-should-patients-have-access-images-reports?GUID=D19C12D8-83B1-4869-969F-926B0ADB9D75&rememberme=1&ts=15112013#sthash.jmseAhuq.4PQSCKgQ.dpuf he said.

“If I estimate one to two calls per week per radiologist, I may be overestimating it, - See more at: http://www.diagnosticimaging.com/pacs-and-informatics/patient-portals-should-patients-have-access-images-reports?GUID=D19C12D8-83B1-4869-969F-926B0ADB9D75&rememberme=1&ts=15112013#sthash.jmseAhuq.4PQSCKgQ.dpuf

Two are better than one: Adding tomosynthesis decreases recall rates

Patients undergoing conventional mammography paired with tomosynthesis had significantly lower screening recall rates than those receiving mammography alone, according to a study published in the December issue of Radiology.

The impact on recall rates was particularly strong for those younger than 50 and those with dense breasts, reflecting tomosynthesis’ ability to reduce false-positives in that patient population.

“Recent work has evaluated the performance of tomosynthesis in a variety of observer performance studies, which collectively have established that the combination of digital breast tomosynthesis with conventional digital mammography can decrease screening mammography recall rates without having a negative effect on sensitivity in the detection of malignancy,” wrote Brian M. Haas, MD, of Yale University School of Medicine in New Haven, Conn., and colleagues.

Haas and colleagues created a study to evaluate the performance of breast tomosynthesis in clinical practice by identifying which patients experienced the greatest reduction in screening mammography recall rates and to assess the cancer detection rate.

Participants were selected from patients presenting for screening mammography in a one year period between October 2011 and September 2012 at four clinical sites. These sites all used digital mammography and included breast imaging clinics in an academic tertiary care hospital, two outpatient radiology centers, and a mobile van-based mammography unit. Tomosynthesis was the preferred method of screening when available, and was performed in combination with mammography when feasible.

Eight breast imaging radiologists interpreted the exams. Recall rates were calculated for the two groups and stratified by breast density and age. During the study, 13,158 patients underwent screening mammography, 6,100 underwent tomosynthesis plus mammography, and 7,058 underwent digital mammography alone.

The overall recall rates for patients in the tomosynthesis group were 8.4 percent and 12 percent for the conventional imaging group. When the recall rates were stratified according to breast density, results demonstrated reduced recall rates for the combination compared with mammography alone for all breast density groups. Significant differences were found for scattered fibroglandular breast density, heterogeneously dense breasts, and extremely dense breasts.

When stratified according to patient age, reduced recall rates were evident with tomosynthesis plus mammography for all age groups. Significant differences were found in patients younger than 40, patients 40 to 40 years old, and patients 60 to 69 years old.

Both younger age and greater breast density were significantly associated with higher risk of recall.

There was a 9.5 percent increase in the cancer detection rate with tomosynthesis; 2,018 women would need to be screened with tomosynthesis to detect one additional cancer beyond that detected by mammography individually. 

“When adopted, tomosynthesis promises to alter the mammography workflow by decreasing screening rates and to subsequently improve the mammography experience for many women,” wrote Haas and colleagues. 

Steere, Anna. "Two are better than one: Adding tomosynthesis decreases recall rates." HealthImaging. 24 November 2013.

Web. 3 December 2013. <http://www.healthimaging.com/topics/womens-health>.