1. Open the Hatch: Utilization of Web Portals in Radiology
C. Harnain, M.D., M.B.A.
D. Williams, M.D.
P. Gerard, M.D., FACR
A. Gilet, M.D.
Z. Lefkovitz, M.D., FACR

2. Purpose
We discuss various ways web portals can be utilized in radiology which not only allow patients to have more information and access to their health records but also helps radiologists and hospitals meet Stage 2 criteria set forth by the CMS.
Doing so allows radiologists and hospitals to participate in the Medicare and Medicaid Electronic Health Record Incentive Program.

3. What is a web portal?
Provides secure communication between patients and healthcare providers while being HIPAA compliant.
24 hour accessibility to allow patients to gain information and have clinical interactions with healthcare providers at their convenience.
A patient web portal is a gateway into a medical practice for patients.

4. Medicare and Medicaid EHR Incentive Programs
Electronic Health Record (EHR) Incentive programs provide financial incentives for the meaningful use of EHR technology.
To receive incentives, providers have to demonstrate meaningful use of EHR by meeting thresholds.
Stage 2 requirements involve use of web portals and is set to be effective in 2014.

5. CMS Guidelines Methods
Stage 1:
Meet 19/24 meaningful use objectives. Use of an EHR for at least 90 days in year 1 and a full fiscal year subsequently.
Stage 2:
Core objective of using secure electronic messaging to communicate with patients on relevant health information.
Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the professional.
Provide patients the ability to view online, download and transmit their health information within 36 hours after discharge from the hospital.

6. Out with the old, in with the new
More often than not, patients coming in for radiologic exam are not well informed about the purpose and details of the exam.
This leads to increased patient anxiety and suboptimal patient care.
Utilization of a patient web portal will allow patients to log in and view credible information and details about their exam.
For example, patients scheduled for an MRI of the lumbar spine can obtain information as to what an MRI is, what will happen during the MRI, and specifically why the healthcare provider ordered an MRI.
In doing so, anxiety levels hopefully will be less and a patient will be well informed.

7. Quicker Feedback
Patients undergoing radiologic exams today often wait days or longer for exam results. Unfortunately, some patients never obtain final results.
The prolongation is usually secondary to the ordering physician serving as a gatekeeper to radiology results.
Utilization of web portals by radiologists allow a direct connection to patients.
Patients can log in and view final radiology reports at their convenience.

8. Streamlining a Department
Scheduling and cancelling examinations by staff utilize time and resources.
Web portals allow patients to schedule exams for times convenient to them and at their leisure.
Doing so, enables the front desk to utilize their time and resources elsewhere in a department, increasing efficiency.

9. Ease of Access
CMS Stage 2 core objective: Requires providers who transition or refer a patient to another setting of care or provider of care to provide a summary of care record for more than 50% of transitions
Web portals can allow patients to view the images of their study and potentially download these images onto a storage device.
Having their studies literally at their finger tips can facilitate care of the patient between providers.
Patients can provide these images to other providers upon request with greater ease.

10. Implementation Strategy Results
While younger patients and radiologists may feel more at ease with the utilization of web portals-- the aged Medicare patient, older radiologist, or those not as tech savvy may feel uncomfortable with this transition.
As with advances in PACS and Powerscribe, adequate training by RIS should be performed for all radiologists and essential staff.
Workshops and tutorials either at radiology offices or offsite locations should be available for patients.
Gradual offering of services through the portal should be implemented in order to reduce technical glitches and to decrease a sense of overload.

11. Conclusion
As the Internet continues to be more connected to healthcare, insurance companies and government agencies such as CMS continue to push for electronic health information web portals to be increasingly utilized.
Patient education, reading final reports, viewing images and scheduling of exams are all ways web portals can be utilized in Radiology.

12. Contact information and References
For further information please contact:
Dr. Christopher M. Harnain, M.D., M.B.A.
Westchester Medical Center
Valhalla, NY 10595
References: