June 26, 2013
Patient Imaging Portals
Making medical images available to patients allows them to be more engaged in their healthcare.
Article from Advance for Imaging & Radiation Oncology
Patient scans as Facebook fodder? It could happen, says Randall Stenoien, MD, CEO of Houston Medical Imaging (HMI), where the adoption of a patient portal has not only streamlined work and cuts costs, but has allowed for greater patient engagement--including potential Facebook postings.
"There's a certain novelty factor involved for patients who might say, 'Hey, I want to see my fracture and put it on Facebook,'" said Stenoien wryly, but he emphasized that there is certainly nothing frivolous about sharing images and reports with patients. Providing a conduit to that direct access encourages patient education, shared decision-making and heightened satisfaction. In the end that adds up to better outcomes--and a better business model.
HMI provides about 40,000 high-tech exams each year from its three Houston sites which offer imaging services across all modalities. Stenoien originally introduced an imaging portal as a way to provide more value to referring physicians.
"But there was a low take-up rate by doctors," he explained. "A lot of computers were not HTML 5-ready, and some doctors were just too busy to look at images on a screen. The adoption rate was dismally low."
Yet because he was so impressed by the usefulness of the technology, Stenoien decided to travel a different path--specifically the MyVue patient portal from Carestream. "I knew it was a great product, and I wanted someone to be able to use it. I was curious to see what the adoption rate would be with patients and thought that instead of the 1 or 2% utilization I saw from doctors, maybe I'd see 10 or 15% utilization from patients."
That turned out to be an underestimate. The patient adoption rate has been 50%. "Almost all patients sign up to use the portal, and half of them activate. And why not? Hey, wouldn't you want to see your images? Wouldn't you want to see your reports? Wouldn't you want to decide who you share them with?" asked Stenoien. "Once patients get past the novelty of it and really look at their studies, they are empowered to ask questions, forward images to others for consults, grant others access to their images. It allows the patient to be more personally engaged with their healthcare, their body, their financial decisions pertaining to care."
Providing a unique means of self-visualization for patients has been a market differentiator for HMI in a highly competitive business climate. "I know that our future survival is based upon attracting more patients every year," Stenoien noted, "and I know that at HMI we are doing twice as many exams now than in 2005 and 10% more this year than last year. While that can be attributed to quality imaging and good service--whether it's report distribution or the way in which we share information--it all helps build our business.
We have attracted more international interest, as well. For example, we had an oncologist in Panama who needed to see images. So his patient signed up for MyVue remotely, then he invited the oncologist into his portal to see the images. That oncologist was so pleased with the access that he has since referred more Panamanian patients to us."
The portal has roped in other business-positive results. For example, HMI has been able to cut labor costs of burning now-unnecessary CD copies of images--CDs that were slow in transport and that could get lost or damaged along the way. Stenoien estimated using MyVue could save HMI about $15,000 a year just by cutting out the CD burning/courier/labor expense.
Initially Stenoien was concerned that introducing high tech to patients might be fraught with user glitches that could result in a flood of service calls to HMI. That hasn't happened. "At most we may get a couple of calls about resetting a password. But we get very few calls about how to use the portal; it's extremely intuitive. Very, very little support is required." What has happened, said Stenoien, is HMI has emerged with a public reputation for being aware of trends in medicine and a forward-facing proactivity. "I know when we qualify for Meaningful Use next year, we will qualify in Stage 2 based upon our patient portal. That's huge."
While the adoption of a portal has direct effects on individual adopters and end-users, certainly the larger effects will be on healthcare in general, and the patient experiences and outcomes it delivers.
"As we begin to engage our patients and our doctors, we are all going to end up on large health information exchange platforms," said Stenoien. "We will be able to access different patient images and read reports done at different hospitals, imaging centers, physician offices. Costs will be cut as duplicate tests can be avoided and fewer follow-up exams will be required. Patients will be spared unnecessary exposures and angst."
Having enumerated the upside to patient portals, ADVANCE asked Stenoien to list the downsides. "Well, some of the doctors are not particularly happy that their patients are seeing images and reports so quickly," he admitted with a small chuckle. "Patients are apt to call and say, 'Hey, this report is already available, how come you haven't called me yet?' So yes, I've had some push-back from a few doctors. But when I explain the value of the portal, they accept it as progress and we all move forward. Having increased patient involvement just serves to remind us that we have a real responsibility to be proactive with information and do the best we can intellectually for our patients."
So what would Stenoien tell other imaging centers and facilities considering the adoption of a patient portal? "Don't do it," he said with a laugh, "then HMI will be even more successful as the only ones using it." With the joke under wraps, Stenoien concluded, "From the perspectives of patient engagement/satisfaction, outcomes, cost-cutting and Meaningful Use, the arguments for imaging portals are extremely compelling. For HMI, it's been a pleasant surprise."