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Objective:
There is a growing opportunity to enhance the patient experience in radiology, including engagement with patients through radiology results. Our center provided patients with access to radiology reports, full exam images, and the ability to download and share images through the patient portal. The purpose of this study was to characterize patient interactions with their imaging results to help support initiatives to make reporting more patient friendly.

Materials and Methods:
This was an IRB-approved, retrospective study that included diagnostic x-ray (XR), ultrasound (US), CT, MR, mammography (MG) and PET examinations completed July 2020 through June 2021. Examination details were queried from the hospital information system (Clarity, Epic Systems, Verona, WI) and filtered to include only eligible radiologic examinations. Access logs of radiology reports were provided by the vendor of the patient portal (MyChart, Epic Systems, Verona, WI) and joined with the examination details. Image-access data were extracted from the server logs of the embedded viewing application (Hyland NilRead, Westlake, OH) and matched with the examination records. Patient age, preferred language, and details of report and image access through the patient portal were recorded. Descriptive statistics were computed.

Results:
The study included 1,759,348 examinations (38% XR, 24% US, 15% CT, 12% MR, 11% MG, and 1% PET); 53% of reports were viewed by patients. Among these, 45% of patients also viewed their images; 0.5% of images were downloaded and 1.0% of images were shared. Reports were viewed for 70% of MR, 67% PET, 56% US, 56% MG, 53% CT, and 45% XR. Images were viewed for 40% of MR, 39% PET, 25% XR, 25% CT, 24% US, 18% MG. MR had the highest rate of downloading (1.5%) and sharing images (3.7%). Reports were viewed for 58% of patients aged 0-59, 50% for 60-79 and 34% for 80+. 8% (73,876 / 929,948) of the viewed reports were in patients that did not have English as their preferred language. Reports and images had peak viewing at 10am-12pm, 2-4pm, and 6-8 pm. 74% of images were viewed on a smartphone, 25% on a desktop, and 1% on a tablet.

Conclusion:
A large fraction of patients viewed their reports and images; 34% of results were viewed by patients aged 80 and older, indicating that patients across age groups can benefit from engagement efforts. Peak viewing periods may result in patient outreach to referrers during those times. Most patients used smartphones to view their images, emphasizing the need to create apps with optimized user interfaces. A total of 17,974 images were shared electronically, potentially reducing the inconvenience of CDs. In summary, a large number of patients view their reports and radiology examination images. This reflects a need for better methods to communicate and illustrate findings directly to patients, such as video reports.