In a new survey, patients overwhelmingly say they’d like their results immediately — even if their provider has not yet reviewed them and even if the news is bad.
In April 2021, new rules went into effect requiring health care providers in the United States to make all results and clinical notes available immediately to patients.
“Online patient portals have emerged as important tools for increasing patient engagement,” said study co-author Catherine DesRoches, executive director of OpenNotes, a movement focused on increasing information transparency in health care based at Beth Israel Deaconess Medical Center in Boston. She is also an associate professor of medicine at Harvard Medical School.
“They enable patients to access information, participate in medical decision-making and to communicate with clinicians,” DesRoches said in a medical center news release.
“Prior studies performed by OpenNotes investigators established immediate release of clinical notes as a recommended best practice,” DesRoches added. “However, releasing test results to patients immediately, often before a clinician can provide counselling and context, was yet to be studied widely and remains controversial.”
Researchers analyzed survey responses from more than 8,100 patients and care partners who accessed their test results through an online patient portal account between April 2021 and April 2022.
Patients had been tested at University of California, Davis Health; University of Colorado Anschutz Medical Center in Aurora; University of Texas Southwestern Medical Center in Dallas, and Vanderbilt University Medical Center in Nashville.
Eight in 10 patients had reviewed at least one test result in the past month. About 57% reported normal findings.
About 90% of those with normal results indicated they would prefer receiving their result via the patient portal.
About 96% said they preferred receiving results through the patient portal as soon as they are available, even if their provider had not yet reviewed them.
Fewer than 8% reported being more worried after viewing test results.
Almost half of those who saw their results before hearing from a provider reported feeling less worried after reviewing their results through the portal.
In those who had results that were not normal, about 84% reported less or no change in their level of worry. They were more likely to report being more worried, or much more worried, than those reporting normal results, 17% versus 5%.
While patients receiving abnormal results are at an increased risk for worry, more than 95% who received abnormal test results still reported preferring to continue to receive immediately released results through the portal.
Counseling by the health care team before tests were ordered was linked to reduced worry among patients with abnormal results.
“Respondents overwhelmingly preferred to receive test results through the patient portal, even if it meant viewing results prior to discussing them with a health care professional,” said co-author Liz Salmi, communications and patient initiatives director of OpenNotes.
“As health care systems continue to navigate this new era of health information transparency, balancing patients’ expectation of immediate access to their information with the need to manage increased worry is important,” she said in the release.
Salmi noted that additional research is necessary to better understand the nuance of worry from receiving abnormal test results, especially as it relates to a newly diagnosed condition such as Huntington’s disease or cancer.
Study findings were published in JAMA Network Open.
The U.S. National Library of Medicine has more on patient portals.
SOURCE: Beth Israel Deaconess Medical Center, news release, March 20, 2023
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