Effective March 20, 2023, Albertans will be able to view diagnostic imaging reports in MyHealth Records (MHR), which is the single access point for Albertans’ personal health information. These reports will be viewable through the MyPersonal Records (MPR) application. According to Alberta Health, “this change is being made to provide Albertans with more access to their health information, and as an additional safety net for patient care within the system. These reports will be viewable with no imposed delay.”
Alberta Health has advised that diagnostic imaging reports from all Alberta Health Services diagnostic imaging facilities and most community diagnostic imaging facilities will be included in MPR. Once the changes are in place, users will see reports from March 20 forward. Importantly, past diagnostic imaging reports will not be available through MPR.
To access their diagnostic imaging results, patients will first need to create their MyAlberta Digital ID and create a MyHealth Records account.
What does this mean for physiotherapists?
Patients currently have access to laboratory results, records of medications dispensed, and immunization records. Following the change, patients will have immediate access to diagnostic imaging results such as x-ray, MRI, and interventional radiology results.
All physiotherapists should anticipate that patients may access diagnostic imaging reports and may attend physiotherapy appointments with questions about diagnostic imaging findings and the implications of those findings.
When responding to patient questions about diagnostic imaging findings for tests that the physiotherapist did not order, physiotherapists are advised to:
- Limit their comments regarding diagnostic imaging findings to topics that are within the scope of practice of the physiotherapy profession and their own individual competence.
- Direct the patient to the primary care provider who ordered the diagnostic image for a comprehensive discussion of the findings, being attentive to the fact that the patient may not be aware of the rationale or indication for which the test was ordered.
- Reinforce general health messaging regarding the prevalence and significance of incidental findings that may be included in a diagnostic imaging report, and which may be a source of concern for the patient. For example, sharing key messages related to the prevalence and significance of incidental findings of degenerative disc disease or osteoarthritic changes.
The Performance of Restricted Activities Standard of Practice requires that physiotherapists who are authorized to order diagnostic imaging:
- explain the rationale for the diagnostic imaging to the client and
- explain the results of the diagnostic imaging to the client.
In response to increased patient access to their diagnostic imaging results, the physiotherapist must anticipate that the patient will review the results of diagnostic imaging before the results are reviewed by the physiotherapist.
Physiotherapists should therefore proactively discuss potential findings and their implications prior to making a referral, to avoid undesirable outcomes such as increased patient anxiety related to incidental findings and unnecessary follow up investigations which are costly and result in additional, unnecessary radiation exposure for the patient.
Prior to making a referral, physiotherapists authorized to order diagnostic imaging are expected engage in pre-test counselling of their patients, providing information about:
- Possible imaging results and the implications of those results
- Common incidental findings and their relevance to the client’s health status
- That the patient will be able to see the result automatically (i.e. the physiotherapist does not “release” the result to the patient)
- That the patient may see the result before the physiotherapist does
- How the physiotherapist follows up on diagnostic imaging results
- How the patient can contact the clinic regarding their results and any questions they may have.
Physiotherapists with authorization to order diagnostic imaging should consider any systems, policies or processes they need to implement or update in order to manage a potential increase in patient contacts and queries related to findings from diagnostic images they have ordered. Physiotherapists authorized to order diagnostic imaging are required to do so for their own clients only and for the purpose of assisting in the management of the patient’s physiotherapy care. Ordering diagnostic imaging and communication regarding the results of diagnostic imaging are to occur within the context of providing a physiotherapy service. Physiotherapists do not charge additional fees to review the results of diagnostic imaging as this is part and parcel of the physiotherapy service.
