Most patients prefer receiving immediate test results through electronic portals

Key takeaways:

• Most patients wanted to receive test results as soon as possible through online portals, even if a provider did not review them.
• Researchers said this remained true for patients who received abnormal results.

Nearly 96% of patients said they preferred to receive test results immediately through a patient portal, even if their health practitioner had not reviewed them yet, a recent study found.

Overall, this finding persisted for patients who did not receive normal test results, according to researchers. However, these patients were more likely to experience increased worry than those who received a normal result.

In recent years, Bryan D. Steitz, PhD, a postdoctoral research fellow at Vanderbilt University Medical Center, and colleagues wrote that online patient portals have become a tool for patients to engage in clinical decision-making.

“However, the benefit to immediate release of test results may be offset by unintended consequences to patient well-being and confidentiality,” they wrote in JAMA Open Network. “Information blocking was intended to provide health care practitioners time to review and discuss results with patients when indicated. Delays and suppression were common for results associated with misinterpretation or emotional distress.”

To better understand patient attitudes toward immediate online delivery of test results, the researchers surveyed 43,380 participants across four academic hospitals. The patients had a median age of 64 years and 63% were women.

Overall, 80.3% of respondents reported receiving at least one test result in the last month. Nearly all patients (90.2%) said they would prefer result delivery through a patient portal in the future. Additionally, 95.7% wanted to receive results through the portal as soon as the results were available, even if the results had not yet been reviewed by a health care practitioner. Furthermore, 95.3% of patients who received abnormal results wanted to continue receiving immediate results through the portal.

Only 7.5% of patients were more worried after reviewing test results. Of those who viewed a result before talking to a health care practitioner, 45.9% were less worried after seeing the result.

Patients who had abnormal results were more likely to be more or much more worried compared with those who received normal results (16.5% vs. 5%).

The researchers conducted a pooled random-effects model to further examine the level of worry as a function of whether test results were normal or abnormal. They found that abnormal results increased the level of worry compared with normal results (OR = 2.71; 99% CI, 1.96-3.74). Steitz and colleagues wrote that this supports previous research and may be “potentially due to difficulty interpreting the results in the context of their own health.”

However, the fact that almost all patients who received abnormal results wanted to continue receiving immediate results through patient portals in the future “suggests that there may be benefits to receiving abnormal results online, such as allowing patients to choose where and with whom to view such results,” they wrote.

The researchers highlighted a need for further research on best practices for precounseling, which may help address patients’ fears.

“Precounseling strategies might encompass both technical and social-technical approaches, including in-person anticipatory guidance, improved asynchronous communication, and portal-based educational materials,” they wrote. “Other strategies include 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.”

References:

• Steitz B, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.3572.
• Patients prefer immediate access to medical test results online, even if it’s bad news. https://www.newswise.com/articles/patients-prefer-immediate-access-to-medical-test-results-online-even-if-it-s-bad-news. Published March 20, 2023. Accessed March 21, 2023.