eHealth provides unmatched opportunities to improve healthcare, but also raises questions of patient confidentiality. Sharing data must be done appropriately, to encourage patients to help advance research, such as through population screening. Radiologists communication skills must be improved with adequate education, and radiology reports should be made more accessible to patients, experts will explain in a Professional Challenges session.
Patients with serious diseases are usually very willing to donate their data to advance research and help future generations. But researchers must remember that patients own their data, and it must therefore be treated with caution, explained Erik Briers, PhD, from Hasselt, Belgium, a representative of Europa Uomo (European Prostate Cancer Coalition) and the European Cancer Patient Coalition.
“Patients in life-threatening situations are not against sharing their data. The problem may be at the other end: researchers may sometimes unwillingly violate patients’ rights, by sharing data with each other in a non-safe way,” he said.
With the possibilities offered by big data, many engineers, data scientists and other non-medical professionals are involved in studies, creating new potential risks of leaking data. “While medical doctors are used to following strict deontological and ethical rules when it comes to their patients, there is no way of making sure that non-MD researchers will,” he said.
Leaking patient data, samples or biobank material could have serious implications for a patient’s socio-economic life, by giving third parties – i.e. banks, health insurances and employers – access to sensitive information.
Research should be conducted according to the concept of risk sharing, Briers argued. “If I agree to share my data, I know there is a risk, which should be properly tackled by the people handling my data. There must be an agreement and patients need guarantees that their data are being processed in a safe environment,” he said.
Big data can help extract meaningful information from medical files and identify at-risk populations for screening. Patients’ participation is fundamental to making progress in that area, so they should not be put off by fears that their data might fall into the wrong hands. “Patients should engage for screening, and advocate and collaborate with everyone who is ready to,” he said.
Communication with patients is key for everyone involved in healthcare, and training radiologists accordingly has become mandatory, according to Prof. Laura Oleaga Zufiría, Head of the Radiology Department at the Hospital Clinic in Barcelona, Spain, who will also take part in the discussion.
“There is a need to educate new radiologists in non-imaging competencies, including communication,” she said.
Communication with patients, but also with other healthcare professionals, is critical to improving the quality of radiology services. Taking time to speak with patients before and after the examination has been shown to improve the patient experience.
Radiologists must treat patients regardless of their background (race, gender, religion, age, etc.) and adapt their language to the person they are dealing with. “We tend to share more details with patients who have a higher level of education, but we do not necessarily do that with those with a lower education. This has to change,” she said.
Residents must also learn about non-verbal communication skills, such as shaking or holding a patient’s hand or using tools to make sure the message is clear, such as a simple pen and paper to help describe a situation.
Talking to the patient during the examination diminishes patient anxiety. And although, in some countries, radiologists cannot communicate a diagnosis before the referring clinician, they can give patients an orientation.
Patient contact skills are particularly useful for radiologists performing interventional procedures and ultrasound and mammography examinations. But as imaging plays an increasingly central role in healthcare, every radiologist must now acquire these competencies. “More and more patients demand to talk to their radiologists, so we have to learn how to do it properly,” Oleaga pointed out.
The ESR European Training Curriculum (ETC) includes a chapter related to communication and management to better reflect the current skills required from radiologists.
“Right now, the four-year Spanish training scheme includes 12 hours on communication and interrelation. This is way too short. We want to raise the importance of these issues and harmonise training accordingly across Europe,” she said.
Another way to improve patient communication is through structured reports; by making them more understandable to patients, according to Wende Gibbs, MD, MA, Assistant Professor of Radiology at the Mayo Clinic in Phoenix, Arizona, USA, who will share related experiences and solutions.
“The new quest for standardisation responds to the increasing desire to show the value of the radiologist, not only to the healthcare team, but to the patient,” she said.
Patient-centred radiology continues to gain support and strength, and a new generation of radiologists sees the value in improving radiology reports for the benefit of patient care and to allow patients to become more involved in their treatment.
“Radiologists increasingly recognise that the language used in the traditional prose report is variable and confusing – characteristics that hinder comprehension for the ordering physician, the patient, and even other radiologists who perform the follow up examinations,” she said.
With artificial intelligence, new tools are being developed that will help to improve patient care and radiologists’ daily workflow, such as standardised language, common data elements, macros and templates, which Gibbs will detail in her presentation.
The session was jointly organised by the ESR Subcommittee on Professional Issues and Economics
in Radiology (PIER) and the ESR Patient Advisory Group (ESR-PAG).
Professional Challenges Session
PC 8 Patient engagement, visible radiology and eHealth
Jointly organised by the ESR Subcommittee on PIER and ESR Patient Advisory Group (ESR-PAG)
- Clinical services, communication with patients: which kind of report/language is expected
- Patient engagement in research: donation of data, risk-sharing in oncology, incentives for screening
Erik Briers; Hasselt/BE
- Patient access to reports and images: solutions and experiences
Wende N. Gibbs; Phoenix, AZ/US
- Education and training
Laura Oleaga Zufiría; Barcelona/ES
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Sobez LM, Kim SH, Angstwurm M et al (2019) Creating high-quality radiology reports in foreign languages through multilingual structured reporting. Eur Radiol. 29(11):6038-6048: european-radiology.org/6206
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