Healthcare transparency is a long-term goal for federal health officials, and giving patients free and easy access to their medical records has become a main target in the fight for interoperability.
Since 2021, information blocking has been prohibited, meaning patients have the right to see their electronic health records and receive immediate release of test results, medication lists and clinical notes upon their request. The hope of health officials is that better access to health information will help patients better manage their own care. An important tool of these aims are patient portals, which has become a key access and engagement point for patients and care providers to communicate. A recent study published in JAMA Network Open aimed to explore how patients feel about receiving test results via patient portals as soon as they are available.
Despite the fact that most patients prefer unfettered access to their health records, releasing test results without context from a healthcare provider remains a controversial practice. For example, patient portals can’t provide adequate counseling or guidance on how to interpret abnormal or sensitive results, which could contribute to negative emotions. There are varied results when it comes to how and when patients want to receive test results, and some patients prefer to receive results directly from their provider when they can be discussed, ask questions and come up with a care plan.
Researchers surveyed a large cohort of patients and care partners receiving immediately released test results from a patient portal at four geographically diverse academic medical centers––University of California, Davis Health; University of Colorado Anschutz Medical Center; University of Texas Southwestern Medical Center; and Vanderbilt University Medical Center.
More than 8,100 patients responded to the survey, which included 29 questions in six domains: (1) demographics and portal user role, (2) test result information, (3) result review behaviors, (4) education and health care practitioner follow-up, (5) effects on health and well-being, and (6) preferences for future results.
Overwhelmingly, most respondents said they wanted to receive their test results right away via the patient portal. The survey queried individuals who had accessed the patient portal at least once in the past year.
“When asked about their preferences for contacts about future test results, 7046 of 7814 respondents (90.2%) indicated that they would prefer result delivery via the patient portal,” wrote first author Bryan D. Steitz, PhD, of the Department of Biomedical Informatics, Vanderbilt University Medical Center, et al. “Nearly all respondents (7520 of 7859 [95.7%]) indicated that they wanted to receive results through the patient portal as soon as results were available, even if their health care practitioner had not yet reviewed a result.”
In addition, 95% of respondents who received an abnormal test result said they wanted to continue to receive immediately released results through the portal.
In response to concerns for negative emotions about patients viewing not normal results before speaking with their care provider, almost half (2513 of 5473 [45.9%]) reported feeling less worried after reviewing their results through the patient portal. Only 7.5% reported feeling more worried after viewing their results on the portal. Among respondents with abnormal blood test and imaging results, 16.0% and 17.5%, respectively, reported more worry or much more worry compared with those with normal blood test (4%) and imaging results (5.8%).
One way to potentially combat this additional worry is to provide counseling prior to testing, the researchers found. In addition, researchers suggested “optimizing existing patient portal interfaces to give users control over their notification preferences related to sensitive or abnormal results or timing the release of test results during working hours.” They also noted that more research into different strategies to mitigate emotional distress over not normal test results is suggested.
Researchers also noted several limitations in their study, namely that they only surveyed patients at four geographically diverse medical institutions. Results may not necessarily be generalized outside these populations. In addition, all patients in the study used Epic’s MyChart patient portal, and vendor differences could influence users’ perceptions.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."