The feel-good factor: why experiences matter to your radiology business
By Richard Kemkers Innovation Program Manager at Philips Research with a strong focus on Diagnostic Imaging
Estimated reading time: 6-8 minutes
How is it possible that in 2018, patients undergoing imaging (and the staff who care for them) still report such poor experiences? At RSNA – the largest global radiology conference starting this weekend in Chicago – I expect to see a lot of innovations that help enable the transformation of care delivery. But I believe we need to do a better job when it comes to how people feel about their care experiences.
Where are the pain points? A recent Philips study shows that while patient satisfaction tends to be high during the referral process (at around 80%) it drops to around 25% during intake and stays at that level throughout the procedure and during follow-up. This suggests we need to do more to improve how we prepare patients before the scan and how we provide feedback to patients during the examination.
From my personal experience, I could not agree more. Let’s take MRI scans as an example. Although I have been working in the industry for more than 20 years, I have never had an MRI exam myself. But my daughter has – she recently needed one to check her spine. I was allowed to accompany her into the room, and found that just sitting at the end of the bore was intimidating, especially for the 30+ minutes that it took to complete the procedure. Afterwards, she told me that she didn’t like how the machine made unpredictable loud noises and seemed to take forever.
We need to do more to improve how we prepare patients before the scan and how we provide feedback to patients during the examination.
The scan time typically is quite long, ranging from 10 minutes up to an hour, and during the procedure it is very important that patients try not to move. This is a particular challenge for patients who suffer from serious pain, which often is the reason for the imaging exam in the first place. Spending that length of time in a restricted space can be quite daunting; in fact it can lead to anxiety and claustrophobia attacks. If patients do move or panic, the scan will most likely need to be repeated. This obviously leads to additional costs: studies show that sub-optimal and repeat imaging contributes to up to $12 billion in charges in the US alone.
Knowing what to expect
Other factors are important as well. In fact, the cues that patients get from their care team – whether within the hospital or from their individual caregivers can really impact the experience overall. Communication and comfort are critical components for both patients and care providers.
I believe that redesigning the patient journey could make a big difference. Let me explain what I mean. What if the patient can start to prepare already at home for the scan, whether it’s for an MRI, or a CT or Nuclear Medicine scan, each of which have their own procedures that are often unfamiliar to the patient. Patients, especially children (and their parents!), should know what to expect in order to reduce any fears.
Many hospitals already provide online information about what to expect during the various procedures and how to best prepare. But with current technology we are able to do more, via interactive services that give clear instructions and guidance on how patients can prepare -- for instance via an easy-to-use app.
Also, during the imaging itself, I think we can do better in coaching the patient real time to provide comfort and guidance and improve results.
Essentially, the imaging equipment can detect and adapt to the mood of the patient, calming them down.
We should help to calm patients like my daughter by providing them with continuous feedback on the progress of the procedure.
One of the ways we can already do this is via an animation projected onto the back wall of the room, which the patient can see via a mirror, to give a sense of progress and control. If we then combine this with contactless monitoring of the patient’s breathing and other vital signs, we could create a virtuous feedback loop. Essentially, the imaging equipment can detect and adapt to the mood of the patient, calming them down.
At Philips, we have already seen that distracting the patient with our Ambient Experience solution can help to reduce repeat exams by as much as 70%. We expect a knock-on effect with other areas of the care experience too, such as reduced waiting times, improved rescheduling and reduced staff overtime.
Adaptive imaging solutions
Which brings me to my next thought: we also need to improve the experience for healthcare professionals. There is increasing pressure to lower healthcare costs, at the same time the demand for medical imaging is increasing -- resulting in a higher workload for radiology staff. This means that they are more likely to experience burnout, with almost half of radiologists reporting classic symptoms like fatigue, anxiety, and doubts about high-quality, meaningful impact on clinical care. I believe we can and should do more to support them.
Just reducing the complexity of operating medical imaging systems would be a big step. It takes multiple years to learn to operate an MRI scanner. Part of that complexity lies in selecting the specific sequences that are required to optimally assess a particular region of the body.
Could we enable more consistent, reliable scans that take less time and enable radiology staff to spend more time with patients?
As our industry takes increasing steps into artificial intelligence (AI), we are starting to create medical imaging machines to simplify tasks for radiology staff, reduce exam time and increase the quality of the images at the same time. For example, machines can now pre-select protocols by learning from previous exams which one worked well, enabling more consistent, reliable scans that take less time and enable technologists and radiologists to spend more time with patients.
Hitting all four aims
At the RSNA event, alongside innovations in AI, I expect we will continue to discuss the ongoing pressures faced by the need to reduce costs and improve outcomes. I strongly believe that improving patient and staff experiences, which make up the other two of the four elements of the quadruple aim, will have an equally powerful effect on the industry.
 The Patient Experience in Imaging Study was conducted in the summer of 2017 by Kantar TNS, in the Netherlands per order of Philips. It was based on prior qualitative research conducted in April-May 2017. N=603. USA=297; GER=306. Interviews were approximately 25 minutes. US Male=138; US Female=159. GER Male=163; GER Female=143. Ages 18-25: US=13, GER=21. Ages 26-59: US=105, GER=136. Ages 60+: US=179, GER=149. The project team included Pascal van der Giessen and Maartje van Diepen (Project Leads) and Pieteke Dijkstra and KatjaFieguth.
 Report by research firm Reaction Data.
 A study from Herlev, Denmark, on the effect of Philips In-bore on re-scans in a sample of adults and children:Herlev hospital measured the total number of scans and rescans on their 6 Philips MRIs, one of which had In-bore Connect and Ambient Experience. In this study, they collected data on 6 scanners for one full year (2014): in total 14,329 scans (on adults and children).Result: With the In-bore Connect and Ambient Experience patients are more compliant and move less, resulting in 70% less rescans (compared to the average of the other 5 Philips MR scanners without Ambient Experience and In-bore Connect). https://www.philips.co.uk/healthcare/education-resources/publications/fieldstrength/patient-comfort-leads-to-first-time-right-imaging, visited 15/11/2018.
 Medscape Physician Lifestyle Report 2015
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