What the Patient Wants: An Analysis of Radiology-Related Inquiries From a Web-Based Patient Portal

With the development of patient portals, the opportunity exists to identify gaps in practice by analyzing priorities patients place on the receipt and comprehension of radiology reports. Our purpose was to describe the nature of radiology-specific patient information requests by analysis of patient-initiated messages submitted through a web-based electronic patient portal.

Institutional review board approval was obtained and informed consent waived for this HIPAA-compliant retrospective cross-sectional study. All patient-initiated messages submitted to the web-based patient portal at a large academic medical center between October 1, 2014 and December 11, 2014 were analyzed. Messages containing radiology-specific key terms including "x-ray," "xray," "xr," "ct," "cat," "mri," "scan," "ultrasound," "image," and "radiology" were identified and messages categorized by content. The demographics of message writers were also analyzed. Diagnostic imaging studies performed during this period were tabulated by modality. Proportions were compared with χ² tests.

During the time period studied, there were 1,597 messages from 1,489 patients inquiring about 1,609 examinations. Messages containing ≥1 radiology-specific keyword were significantly more likely to originate from women than from men (64% [946/1,489] versus 36% [543/1,489], P < .0001), with 53% of studies (52,322/98,897) performed on female patients and 47% (46,575/98,897) on male patients. The relative percentages of modality-specific patient inquiries were significantly discrepant (P < .001) from actual scan volume for some modalities (MRI: 38% [607/1,609] versus 11% [11,152/98,897], CT: 25% [400/1,609] versus 19% [19,032/98,897], plain radiography: 23% [368/1,609] versus 55% [54,497/98,897]). The most common inquiry was for imaging results (33% [521/1,597], P < .001); these were submitted a median of 5 days (range: 0-368 days) after imaging. The radiology turnaround time (between exam completion in the Radiology Information System and signoff on report) was 5 hours, versus 70 hours for referring provider review. Inquiries about radiation dose or radiation risk represented 0.1% (2/1,597) of all inquiries.

Patients submitting radiology-specific messages through an electronic patient portal are most concerned about imaging results, particularly those pertaining to advanced (CT and MRI) imaging studies.