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- Title
Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal.
- Authors
Steitz, Bryan D.; Turer, Robert W.; Lin, Chen-Tan; MacDonald, Scott; Salmi, Liz; Wright, Adam; Lehmann, Christoph U.; Langford, Karen; McDonald, Samuel A.; Reese, Thomas J.; Sternberg, Paul; Chen, Qingxia; Rosenbloom, S. Trent; DesRoches, Catherine M.
- Abstract
This survey study examines respondents' attitudes and perspectives about receiving immediately released medical test results through an online patient portal. Key Points: Question: What are patient attitudes and perspectives related to viewing immediately released test results through an online patient portal? Findings: In this survey study of 8139 respondents at 4 US academic medical centers, 96% of patients preferred receiving immediately released test results online even if their health care practitioner had not yet reviewed the result. A subset of respondents experienced increased worry after receiving abnormal results. Meaning: In this study, most patients supported receiving immediately released test results via a patient portal, but some patients experienced increased worry, especially when test results were abnormal. Importance: The 21st Century Cures Act Final Rule mandates the immediate electronic availability of test results to patients, likely empowering them to better manage their health. Concerns remain about unintended effects of releasing abnormal test results to patients. Objective: To assess patient and caregiver attitudes and preferences related to receiving immediately released test results through an online patient portal. Design, Setting, and Participants: This large, multisite survey study was conducted at 4 geographically distributed academic medical centers in the US using an instrument adapted from validated surveys. The survey was delivered in May 2022 to adult patients and care partners who had accessed test results via an online patient portal account between April 5, 2021, and April 4, 2022. Exposures: Access to test results via a patient portal between April 5, 2021, and April 4, 2022. Main Outcomes and Measures: Responses to questions related to demographics, test type and result, reaction to result, notification experience and future preferences, and effect on health and well-being were aggregated. To evaluate characteristics associated with patient worry, logistic regression and pooled random-effects models were used to assess level of worry as a function of whether test results were perceived by patients as normal or not normal and whether patients were precounseled. Results: Of 43 380 surveys delivered, there were 8139 respondents (18.8%). Most respondents were female (5129 [63.0%]) and spoke English as their primary language (7690 [94.5%]). The median age was 64 years (IQR, 50-72 years). Most respondents (7520 of 7859 [95.7%]), including 2337 of 2453 individuals (95.3%) who received nonnormal results, preferred to immediately receive test results through the portal. Few respondents (411 of 5473 [7.5%]) reported that reviewing results before they were contacted by a health care practitioner increased worry, though increased worry was more common among respondents who received abnormal results (403 of 2442 [16.5%]) than those whose results were normal (294 of 5918 [5.0%]). The result of the pooled model for worry as a function of test result normality was statistically significant (odds ratio [OR], 2.71; 99% CI, 1.96-3.74), suggesting an association between worry and nonnormal results. The result of the pooled model evaluating the association between worry and precounseling was not significant (OR, 0.70; 99% CI, 0.31-1.59). Conclusions and Relevance: In this multisite survey study of patient attitudes and preferences toward receiving immediately released test results via a patient portal, most respondents preferred to receive test results via the patient portal despite viewing results prior to discussion with a health care professional. This preference persisted among patients with nonnormal results.
- Subjects
UNITED States; ONLINE information services; CAREGIVER attitudes; ACADEMIC medical centers; CONFIDENCE intervals; PATIENT portals; RESEARCH methodology evaluation; PATIENTS' attitudes; SURVEYS; HEALTH; INFORMATION resources; DESCRIPTIVE statistics; ROUTINE diagnostic tests; LOGISTIC regression analysis; ODDS ratio; DATA analysis software; MEDICAL record access control; LEGAL status of patients
- Publication
JAMA Network Open, 2023, Vol 6, Issue 3, pe233572
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.3572