Patient advocate lecture may be a first ever at RSNA

November 28, 2018
by John W. Mitchell, Senior Correspondent
A panel of four physicians and a patient advocate shared their work to improve the patient imaging experience during an educational session Monday at RSNA 2018 in Chicago. While the details of their initiatives differed, they each spoke to a common theme: increasing patient satisfaction works best when it is a commitment, not a matter of compliance.

Moderator Dr. Ramin Khorasani, MPH vice chair, Department of Radiology, Brigham and Women’s Hospital, informed the capacity audience that theirs was one of the few patient experience sessions at RSNA this year. He also advised that the inclusion of a patient advocate, Andrea Borondy Kitts, MS, MPH, may very well have been the first appearance of a trained patient advocate and researcher on an RSNA panel.

Borondy Kitts, a former rocket propulsion engineer, made the change to patient advocacy when her husband was diagnosed with late-stage lung cancer and died. Combined with her own ongoing hip surgery medical issues, she now specializes in working with lung cancer patients and other patients at Lahey Hospital and Medical Center. She also blogs on patient advocacy issues for the Journal of the American College of Radiology and has had several journal studies published related to patient-centric issues.

Despite the data that indicates 20 percent of all medical errors are related to radiology, she reported that her own and other patients’ experiences are that radiologists are not readily available to speak to patients.

“I have yet to talk to a radiologist about my results. The one time I really tried, I was told it was not allowed," she said. She believes there is a big opportunity for radiologists to offer such direct patient communication to improve care. Toward the end of the session, she and Khorasani discussed the concerns radiologists have responding to patient phone calls or emails, due to authentication and privacy concerns.

“Unfortunately, physicians often struggle with HIPAA, which does allow them to speak to their patients to explain results. It would be better patient care if such guidelines were interpreted properly,” Borondy Kitts told HCB News. She said that guideline information was readily available online to assuage physician concerns.

She and another presenter also shared several examples of medical centers and physicians who have designed patient-friendly reports and other communications to enable patients as “care partners.” This can help reduce medical errors and improve the patient experience.

Dr. Keith Hentel, M.S., vice chairman for clinical operations, Department of Radiology, made a presentation about how Weill Cornell Medicine (WCM) deployed informatics to create an advantage in their very competitive New York City market. Hentel, who also serves in operating and patient experience roles at WCM, said that the organization made a decision ten years ago to use data to provide a superior patient experience in a market area with more than a dozen outpatient imaging centers.

Upfront, they are very selective about the staff they hire to represent the center. Either he or another senior executive interviews for every position to ensure new hires are a good match with the organization’s service culture. Hentel advised the audience that the phone, while not high-tech, is the most overlooked weak link in patient satisfaction delivery.

Using data as a guide, they were able to decrease their abandoned call rate to less than one percent since last year. Other strategies include alerting staff to patients with a history of being high-demand, and reconfiguring the registration process to an online portal for faster turnaround times. And, Hentel said, they are trialing patient feedback to provide satisfaction feedback in less than an hour.

Such attention to detail has helped WCM consistently rank as the top outpatient center in their market.

Hentel also noted the difference between patient experience and patient satisfaction, even though many medical organizations tend to use the two terms interchangeably. Patient experience, he explained, encompasses the range of interactions that patients have with the health care system. This includes getting timely appointments, easy access to information, and good communication with health care providers.

Patient satisfaction, on the other hand, applies to whether a patient’s experience about a health encounter was satisfactory. It is a crucial distinction, as two patients can receive the same care. However, one patient may give a high satisfaction rate, while the second patient will give low feedback. The difference is in their expectations, which providers should take the time and effort to determine.