Increasing patient viewership of complex imaging reports: The paradox of the Cures Act.

Background: As a result of the 21st Century Cures Act, radiology reports are immediately released to patients. We determine if readers of radiology reports, via electronic health records (EHRs), and radiology report complexity have changed post the implementation of the 21st Century Cures Act.

Methods: A retrospective observational study was used to analyze 10,000 radiology reports (equal split of CT, mammogram, MRI, X-ray, and ultrasound modalities) per year between 2013 and 2023. Readability was calculated through reading grade level indices.

Results: Patient viewership of their radiology reports via EHRs increased from 3.3 % (95 % CI: 3.0 %-3.7 %) in 2013 to 58.2 % (95 % CI: 57.3 %-59.2 %) in 2023. Once the 21st Century Cures Act's Information Blocking Provision went into effect, there was a significant increase in viewing probability with patients having 1.71 times higher odds of viewing their reports (OR = 1.71, 95 % CI: 1.27-2.32, p < 0.001). This increase in patient viewership held for all modalities tested except CT (P < 0.01). Despite increased viewership, the reading grade level of radiologist dictated radiology reports was greater than the recommended level for health information across all years and modalities tested.

Conclusions And Relevance: Patients are increasingly engaging with their radiology reports, but reports may be too complex for the typical patient. Solutions will be required to improve patient experience with their radiology reports.