JACR: Results on demandmany patients prefer online portals
The internet has made instant, at-home access to entertainment, information and shopping a reality for years. Now, as more providers begin to offer online patient portals, a survey of adult outpatients has shown that online access to radiologic reports either immediately or within a period of a few days is often preferable to waiting for a consultation with a primary care physician, according to a study published in the Journal of the American College of Radiology.
Annette J. Johnson, MD, MS, of the department of radiology at Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues administered on-site electronic questionnaires to determine patient preferences for timing in a system allowing for online patient access to radiologic reports and also patient resource needs after being exposed to the reports.
“Patient portals are increasingly popular, especially given meaningful use standards introduced by the American Reinvestment and Recovery Act of 2009, but early on, few hospitals with electronic health records and portals include radiologic test results access for patients as a feature of the portal to date, with timing for access typically being chosen by providers,” wrote the authors.
A total of 53 people responded to the survey invitation and completed the questionnaire. They were exposed to three simulated clinical scenarios that described a symptomatology and written radiology reports that were normal, seriously abnormal and indeterminate. The reports contained typical medical terminology and participants were asked about their preference in timing for receiving the reports and the educational resources they’d prefer for understanding the reports.
Results varied only slightly by scenario, and many participants expressed a desire for prompt access to their reports. For the nearly normal scenario, 60.2 percent wanted immediate access to the report and another 28.3 percent wanted the report with limited delayed access of three days. Immediate access was also preferred by 45.3 percent for seriously abnormal reports and 45.3 percent for indeterminate reports.
Nearly 80 percent of respondents preferred the portal method over other methods of notification, such as phone calls, mailed letters or in-person clinical consultation.
Most participants indicated they would consult a variety of educational resources, from discussions with physicians and knowledgeable friends to searching the internet and medical dictionaries, to help understand the reports. The authors said this finding implies that patients would recognize they would not fully understand the report, but also noted that internet searches can sometimes have mixed results in terms of reliability.
“Toward this end, we sought to determine if participants would be amenable to using specific websites we recommended and how useful they would find those sites if they chose to access them,” wrote Johnson et al. “Even given presumed variability in individual participants' levels of medical knowledge, nearly 90 percent of participants tried the content-specific sites we offered (all via the [National Library of Medicine] patient site) and found them to be helpful.”
The authors suggested that healthcare organizations considering portal access to radiologic results should offer hyperlinks to reliable medical information and possibly automated systems to deliver lay language to patients.
The study was limited in a few important ways, according to the authors. First, those responding to the invitation to participate may be more interested and inclined to access test results online, so the study results may not be generalizable to less educated or less interested patients.
Another limitation of the study concerns the role of anxiety. The current study did not address anxiety, which could either be alleviated by immediate access to a patient portal or increased due to confusion when viewing results without the guidance of a clinician.
“We suggest that the effects of immediate access on patient anxiety and autonomy among a more diverse population of patients, as well as effects of such access on provider workflow, need to be studied,” wrote the authors.
Annette J. Johnson, MD, MS, of the department of radiology at Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues administered on-site electronic questionnaires to determine patient preferences for timing in a system allowing for online patient access to radiologic reports and also patient resource needs after being exposed to the reports.
“Patient portals are increasingly popular, especially given meaningful use standards introduced by the American Reinvestment and Recovery Act of 2009, but early on, few hospitals with electronic health records and portals include radiologic test results access for patients as a feature of the portal to date, with timing for access typically being chosen by providers,” wrote the authors.
A total of 53 people responded to the survey invitation and completed the questionnaire. They were exposed to three simulated clinical scenarios that described a symptomatology and written radiology reports that were normal, seriously abnormal and indeterminate. The reports contained typical medical terminology and participants were asked about their preference in timing for receiving the reports and the educational resources they’d prefer for understanding the reports.
Results varied only slightly by scenario, and many participants expressed a desire for prompt access to their reports. For the nearly normal scenario, 60.2 percent wanted immediate access to the report and another 28.3 percent wanted the report with limited delayed access of three days. Immediate access was also preferred by 45.3 percent for seriously abnormal reports and 45.3 percent for indeterminate reports.
Nearly 80 percent of respondents preferred the portal method over other methods of notification, such as phone calls, mailed letters or in-person clinical consultation.
Most participants indicated they would consult a variety of educational resources, from discussions with physicians and knowledgeable friends to searching the internet and medical dictionaries, to help understand the reports. The authors said this finding implies that patients would recognize they would not fully understand the report, but also noted that internet searches can sometimes have mixed results in terms of reliability.
“Toward this end, we sought to determine if participants would be amenable to using specific websites we recommended and how useful they would find those sites if they chose to access them,” wrote Johnson et al. “Even given presumed variability in individual participants' levels of medical knowledge, nearly 90 percent of participants tried the content-specific sites we offered (all via the [National Library of Medicine] patient site) and found them to be helpful.”
The authors suggested that healthcare organizations considering portal access to radiologic results should offer hyperlinks to reliable medical information and possibly automated systems to deliver lay language to patients.
The study was limited in a few important ways, according to the authors. First, those responding to the invitation to participate may be more interested and inclined to access test results online, so the study results may not be generalizable to less educated or less interested patients.
Another limitation of the study concerns the role of anxiety. The current study did not address anxiety, which could either be alleviated by immediate access to a patient portal or increased due to confusion when viewing results without the guidance of a clinician.
“We suggest that the effects of immediate access on patient anxiety and autonomy among a more diverse population of patients, as well as effects of such access on provider workflow, need to be studied,” wrote the authors.
Evan Godt, Writer
Evan joined TriMed in 2011, writing primarily for Health Imaging. Prior to diving into medical journalism, Evan worked for the Nine Network of Public Media in St. Louis. He also has worked in public relations and education. Evan studied journalism at the University of Missouri, with an emphasis on broadcast media.