Written by Megan Hilbert
Spoon Feed
In general, patients prefer to review and see their testing results (even if abnormal) via a patient portal even before discussing them with a healthcare provider.
Why does this matter?
With the passing of the 21st Century Cures Act, it became mandatory to make test results, medication lists, and clinical notes immediately available to patients electronically upon their request. The goal was to empower patients to engage in their healthcare and prevent information blocking. For normal results, this seems like a no-brainer, but with non-normal results are we unintentionally increasing emotional distress?
These portals are a’door’able
This prospective meta-analysis surveyed patients at 4 academic medical centers in the United States regarding their opinions toward patient portals. Specifically assessed was “odds of worry as a function of test result normality and pre-counseling.” There is a component of self-selection bias (given that those surveyed were patients who had already accessed their online portal) to this study, making the results not wholly generalizable. Having said that, most respondents (95.7%) preferred to receive immediate access to results through the online portal. Only 7.5% reported an increase in worry prior to being contacted by their healthcare provider. Of the subset that reported increased worry, there was a statistically significant association between worry and non-normal test results (odds ratio [OR], 2.71; 99% CI, 1.96-3.74). This worry was not significantly lessened by pre-counseling (OR, 0.70; 99% CI, 0.31-1.59).
These results seem to support the general positive impressions that I have anecdotally experienced when patients receive their test results via portal while they are in the ED. It tends to afford patients time to formulate questions so that we can have a more informed discussion. Where I still have issue with the portal is when imaging studies demonstrate new masses or other potential life threatening/changing diagnoses. Personally, I would prefer to discuss such results with the patient prior to them reading about it.
Source
Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal. JAMA Netw Open. 2023 Mar 1;6(3):e233572. doi: 10.1001/jamanetworkopen.2023.3572.
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