Study Shows There’s No Time Like the Present for Bad News

The seven-day turnaround time commonly used by hospital imaging staff to give themselves a cushion for reading scans may no longer be sufficient for patients in the Information Age.A pilot study published in the April 2012 issue of the Journal of the American College of Radiology shows that, even when faced with the prospect of digesting bad news without the aid of their primary or referring physician, patients want to know their test results as soon as possible. Nearly half the 53 participants in the study wanted to know the results of their tests right away; another third wanted to wait no longer than three days. Annette Johnson, M.D., associate professor of radiology at Wake Forest Baptist Medical Center and principal investigator of the study said the results were not what she’d expected. “I asked my patients, ‘What would you do if you had this test and you read this result and it’s pretty obvious there’s something bad there?’” Johnson says. “They said it’s more anxiety-provoking to wait for their doctor to call.” Johnson said that her patients were willing to swallow bad news that they didn’t entirely understand for any number of reasons. For one, she says, “they knew when they had the scan that it could be something bad and were imagining that it could be something bad before they got the results anyway.” Her patients told her that they could use the extra time to prepare for their next visit with their provider, schedule a consultation with a specialist, or talk with friends and family members about how to proceed. “Subjects of the study viewed [test results] as another source of information, not as a replacement of discussion with their physician,” she says. Johnson says that even if patients in the study had to mine the information from the technical language of an imaging result, they were more tolerant of doing the research on their own because they had the time to investigate the information for themselves. “Not surprisingly, they knew they did not understand [the language], and they did reasonable things to understand what the words meant,” she says: “they looked them up. “I think we underestimate people,” Johnson says. Johnson also adds that she can empathize with patients who don’t want to wait for imaging results because “as a physician, if I get a test, I know the results that day because I go to whoever’s going to read the study. I don’t have the patience to wait.” “People say they can use that time to get social support or talk with their family or see a specialist more quickly. Johnson says that this information could be used to help assist in planning EHR deployments that allow patients to access their medical records through a web portal. Those facilities with which she says she’s familiar “typically wait a week or more to give patients the access” to their imaging results. “Physicians want that amount of time to make sure that they have the chance to look at the results themselves to make sure that they’re prepared,” she says. “Physicians get results for a lot of different patients from a lot of different places; it’s a challenge sometimes to keep them organized.” Nonetheless, she says, “I’m hoping the findings, the idea, will make hospitals and health systems think twice about putting in a week’s delay or more.”