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E1789. “Choosing our Words Wisely”: Increasing Patient-Friendly Language for Automatic Direct Report Release to Patients
Authors
  1. Christopher Selhorst; Mid Atlantic Permanente Medical Group
  2. Vincent Dam; Mid Atlantic Permanente Medical Group
  3. Wilbur Chang; Mid Atlantic Permanente Medical Group
  4. Andrea Giacometti; Mid Atlantic Permanente Medical Group
  5. Akwasi Jackson; Kaiser Permanente Mid-Atlantic States
  6. Cedric Wilson; Kaiser Permanente Mid-Atlantic States
  7. Ainsley Maclean; Mid Atlantic Permanente Medical Group
Objective:
The direct release of radiology reports to patients is an increasingly prevalent component of Patient-Centered Radiology. Incorporating patient-friendly language into these reports is key to reducing potential patient anxiety and confusion, but may also represent a significant practice shift and challenge for the Radiologist. In preparation for the transition to immediate (MG, CR) or next business day (CT, MR, NM, PET, US) direct to patient release of Radiology reports, we created an education program based on feedback from our referring providers to provide specific guidance to Radiologists on patient-friendly reporting – Choosing our Words Wisely. Reports were delivered via a secure online patient portal within our large integrated healthcare delivery system that performs nearly 800,000 imaging interpretations per year.

Materials and Methods:
Prior to initiating direct report release, a single question survey was sent to our referring providers, approximately 1600 physicians: How provider and patient friendly is the language in our Radiology report? Based on that feedback, as well as best practices from published literature and expert opinion, a workgroup comprised of Radiology Section Chiefs created a set of specific reporting guidelines designed to foster the use of layman’s terms and clear recommendations for patients and ordering providers. These guidelines were curated and presented to the entire Radiology department of 70 radiologists via a 1-hour online course titled “Choosing our Words Wisely”. Course materials were made available for subsequent review online. Direct report release was initiated 22 days later. Four months and ~242,873 directly released reports later, a follow up single question survey was sent to the medical group: Has our patient-friendly and standardized wording in our reports improved the rapidity and ease with which you discuss results with patients?

Results:
Pre-intervention survey: How provider and patient friendly is the language in our Radiology reports? The response rate was 193/1625 (11-12%). 49% of respondents gave favorable ratings (above average), while 14% cited room for improvement (below average) and 37% of respondents gave average ratings. Choosing Words Wisely guidelines were compiled, with 5 key guidelines per section. One example: - Less is more. Avoid words, descriptors or measurements that add no value to a report and generate unnecessary questions, anxiety or concerns for patients. Post intervention survey: Has our patient-friendly and standardized wording in our reports improved the rapidity and ease with which you discuss results with patients? Response rate was 237/1625 (14-15 %). 81% gave positive responses (110 yes, 81 sometimes).

Conclusion:
By engaging radiologist practice leaders within the department to create a set of simple, clear guidelines, we were able to rapidly and effectively address the need for patient-friendly language in the radiology report prior to transitioning to direct report release. Continued reinforcement and updating of guidelines based on continuous feedback and review are planned.