I posted a recent note about some of the pitfalls associated with patient portals that are used by patients to access lab and pathology reports (see: Publishing Test Results in Patient Portals: Holding a Tiger by the Tail). May major point was that lab professionals have not yet totally mastered the "art" of communicating complex test results to physicians and that we are now presenting some of these same results to patients. This presents a very significant challenge that needs to be attended to. A recent article discussed how radiology departments are now increasingly in the same boat with radiology patient portals (see: Bypassing Doctors, Patients Take Charge of Radiology Images, Reports). Below is an excerpt from it. It's very long so link to the whole thing for more information.
Once the exclusive province of doctor-to-doctor communications, radiology images and reports are migrating into the hands of patients, a trend that may soon exert extraordinary influence over the specialty. Using new technologies called "patient portals," patients can now access their medical images and the diagnostic reports on which they are based and decide who will see them. A project involving some of the top medical institutions in the United States is sowing the seeds of patient online access to this information, just as vendors experiment with low-cost means to provide it. Preliminary research has documented that patients overwhelmingly want this access. And the benefits of obtaining it may go far beyond patient empowerment and include immediate and long-term savings to radiology operations in time and money, as well as the streamlining of medical practice overall, potentially laying the foundation for better emergency care and broadly based clinical studies.
Since 2009, the University of California, San Francisco; University of Chicago; Mayo Clinic in Rochester, Minnesota; the University of Maryland in Baltimore; and Mount Sinai Medical Center in New York, New York, have collaborated on Image Share, a project that allows patients to pull their medical images from the Internet cloud. As part of Image Share, these institutions developed Web-based personal health records for participating patients, who arrange with radiology practices to file image and diagnostic reports in those patient records. ....
This is the next revolution in digital imaging," said David Mendelson, MD, Chief of Clinical Informatics at Mount Sinai Medical Center and lead investigator of the Image Share project. "It gives the patient ownership over their records and makes the information more accessible to physicians. Plus, it decreases unnecessary radiation exposure that can be caused by physicians ordering duplicate examinations owing to records not being easily available." At Houston Medical Imaging (HMI), a private imaging provider that operates in 3 sites in Houston, Texas, patients can access their images and reports using software developed by Carestream Health. Patients can register to use the software, called MyVue, after completing an imaging examination at HMI. Accessing their MyVue account as they might an online banking account, these patients can view -- and distribute -- their images and radiology reports to anyone they choose.
Think about the long-term implications of radiology patient portals and, perhaps, some of the future implications for lab/pathology patient portals. Radiology is now providing patient access to the same images that are being used to generate diagnoses as well as narrative radiology reports. As digital pathology matures and surgical pathology images are more commonly posted on pathology PACS servers, I believe that patients will soon have access to these images as well.
The key sentence in the excerpt above is the following: [patients are] accessing their MyVue account as they might an online banking account, these patients can view -- and distribute -- their images and radiology reports to anyone they choose. Some patients will thus now be in a position to participate in discussions/decisions such as whether proposed duplicative imaging studies should be ordered for them or whether to request an additional opinion about a study. Here's the good news in all of this. I suspect that not many patients will assert that they are more skilled in interpreting imaging studies than radiologists as was the case when neurosurgeons and orthopedic surgeons got rapid electronic access to them via PACS servers.