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Presentation: 6:31

Poster attached as supplemental file below


In recent years, the advent of electronic medical records (EMR) and the enactment of the 21st Century Cures Act in 2016 have granted patients unprecedented access to their medical information. This shift towards increased transparency, while beneficial, has highlighted a significant challenge—bridging the gap between complex medical language and patients' diverse literacy levels. A key concern arises from the fact that the average radiology report is written at a 12th-13th grade reading level, while nearly half of the American population reads at an 8th-grade level or below. This discrepancy raises questions about how well patients comprehend the crucial health information now available to them online. Additionally, considering the potentially life-altering nature of some medical findings, understanding the emotional impact of such revelations becomes crucial.

To address these issues, this study focused on patient perspectives and initial reactions to reading complex medical information, specifically using a sample radiology report from a Coronary Calcium CT imaging exam. The study employed structured interviews with standardized questions, revealing that participants often experienced confusion when deciphering the report. They proposed practical solutions, including the use of layperson summaries, visual aids, and comparisons of numerical data with those who had undergone similar imaging exams. These findings serve as a valuable foundation for enhancing the patient-friendliness of radiological imaging reports. By acknowledging the challenges patients face in comprehending these documents, the study suggests potential improvements such as incorporating simplified language, illustrations, and relatable numerical benchmarks. Looking ahead, this research provides a starting point for future investigations into the effectiveness of such changes and explores the potential role of Artificial Intelligence (AI) in generating accurate and easily understandable reports, further advancing patient-centric healthcare communication.

Lay Summary

Electronic medical records are an online collection of information about a patient’s health history, including things such as diagnoses, current medication, laboratory and imaging tests, immunization records, and treatment plans. A piece of legislation called the 21st Century Cures Act was passed in 2016, and this legislation included provisions to promote the use of electronic medical records to improve patient care and their overall health. One specific piece of this legislation banned blocking patients from viewing their health records online, meaning that they would have instant access to new diagnoses, labs and tests the moment they were put into their electronic medical record.

This newfound access to information has raised some concerns that were less prevalent before the 21st Century Cures Act. The first major concern is the gap between the average patient’s reading level and the reading level of reports that are found in the electronic medical record. Much of what is in an electronic medical record is written and documented with the intent that other healthcare providers will read it and take the information into account when caring for the patient. Because of this, these reports typically contain complex, highly technical medical information. For example, the average radiology imaging report was found to be written at a 13th-grade, or college, reading level, while the average American has an 8th-grade reading level. Due to this difference, some patients will likely have trouble understanding the reports in their medical records, which may contain life-changing or worrisome information while being a major source of stress for patients.

There has not been much research on how patients comprehend, emotionally respond, and react to the potentially concerning information found in their electronic medical records. This study further explores these questions by showing participants a normal sample radiology imaging report, and then interviewing them to gain valuable insight into their understanding and reactions related to the radiology report.