Evaluation of the Patient Request Process for Radiology Imaging in U.S. Hospitals

Abstract

Because of the establishment of the patients' right of access under the Health Insurance Portability and Accountability Act, patients have the right to access all information that is included in their designated record set, including imaging studies such as radiography and CT (1). Although federal regulations and policies have focused broadly on improving patient access to their medical information (2-4), there has been little emphasis on access to imaging studies, not merely radiology reports, despite studies that indicate patients prefer to view imaging studies in addition to receiving written radiology results (5-7).Previous studies (8,9) highlighted issues of noncompliance with federal regulation and barriers to access in the general medical records request process. We sought to assess the request process specifically for imaging studies to investigate whether similar barriers exist. Requests for imaging studies are subject to the same laws as requests for other portions of the medical record, in that requests must be fulfilled within 30 days of receipt, in the format requested by the patient if readily producible in that format, with health care providers permitted to impose a reasonable cost-based fee (1). To evaluate U.S. hospital compliance with federal regulations and patient ease of access to imaging studies, our study focused on assessing formats of release, costs of release, processing times, and, more generally, challenges to how patients request imaging studies in a subset of top-ranked U.S. hospitals through a simulated patient experience. Materials and MethodsThis cross-sectional study, conducted between June 6 and December 3, 2018, was approved by the institutional review board as a not human research protocol at Yale University. The requirement of written informed consent was waived for this study.

What are the benefits and risks of sharing patients’ diagnostic radiological images with them? A cross-sectional study of the perceptions of patients and clinicians in the UK

“…Liao and Lee 13 note that there is the potential to raise the profile of radiologists with the general public. This correlates with the work of Lee et al, 10 who highlight such interactions as providing the potential for the evolution of the patient-radiologist relationship and for radiologists to become active partners in their patients' care. 10 Both of these solutions, however, have resource implications for clinicians.…”

“…This correlates with the work of Lee et al, 10 who highlight such interactions as providing the potential for the evolution of the patient-radiologist relationship and for radiologists to become active partners in their patients' care. 10 Both of these solutions, however, have resource implications for clinicians. One way to overcome resource shortages may be found in the work of Cook et al, 14 who explored the potential of an online system to annotate clinical terms with lay definitions.…”

“…To date, where there has been exploration of sharing radiological results with patients, the focus has tended to be on the interpretation of the patient's images. There are varying mechanisms for this, and a study in the USA by Lye et al 10 found that these were complicated for patients. However, the processes do exist.…”

Full Radiology Report through Patient Web Portal: A Literature Review

“…This paper focuses on access to full radiology reports in web portals and, therefore, will concentrate on the limitations of the portal regarding this issue. Many studies mention that there are issues and limitations in the radiology section of patient web portals [2,24,52]. There are many physicians, radiologists, and patients who are dissatisfied with the radiology portion of the web portal [52].…”

2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics: A Consensus Conference Report

“…Unfortunately, this right is neither well monitored nor enforced, and EHR data can be hard and sometimes costly to access. [189][190][191] 4. Researchers, hospitals, and health systems engaging in medical information sharing, including from EHRs, should consider using a Data Governance Board that is patient elected and includes at least 1 patient representative to adjudicate access requests and sharing of medical data.…”