Building a Better Online Portal for Patients to Obtain Radiologic Results

Arenson, Ronald L.

doi:10.1148/radiol.2018182218

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…Phadke et al [61] found that patients with breast cancer prioritize obtaining results as quickly as possible; however, specific patient communication preferences differ depending on age, cancer stage, and education level. Arenson [62] found that patient preference for the method of receiving results varied, but immediate release into a portal was preferred if it was followed by a prompt call or office visit. Evidently, timely access to test results is particularly important for people with cancer.…”

Section: Comparison With Other Literaturementioning

confidence: 99%

Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review

Petrovskaya,

Karpman,

Schilling

et al. 2023

J Med Internet Res

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Background A frequently used feature of electronic patient portals is the viewing of test results. Research on patient portals is abundant and offers evidence to help portal implementers make policy and practice decisions. In contrast, no comparable comprehensive summary of research addresses the direct release of and patient access to test results. Objective This scoping review aims to analyze and synthesize published research focused on patient and health care provider perspectives on the direct release of laboratory, imaging, and radiology results to patients via web portals. Methods PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Searches were conducted in CINAHL, MEDLINE, and other databases. Citations were screened in Covidence using the inclusion and exclusion criteria. Primary studies that focused on patient and health care provider perspectives on patient access to laboratory and imaging results via web portals were included. An updated search was conducted up to August 2023. Our review included 27 articles—20 examining patient views, 3 examining provider views, and 4 examining both patient and provider views. Data extraction and inductive data analysis were informed by sensitizing concepts from sociomaterial perspectives, and 15 themes were generated. Results Patient perspectives (24 papers) were synthesized using nine themes: (1) patterns of use and patient characteristics; (2) emotional response when viewing the results and uncertainty about their implications; (3) understanding test results; (4) preferences for mode and timing of result release; (5). information seeking and patients’ actions motivated by viewing results via a portal; (6) contemplating changes in behavior and managing own health; (7) benefits of accessing test results via a portal; (8) limitations of accessing test results via a portal; and (9) suggestions for portal improvement. Health care provider perspectives (7 papers) were synthetized into six themes: (1) providers’ view of benefits of patient access to results via the portal; (2) effects on health care provider workload; (3) concerns about patient anxiety; (4) timing of result release into the patient portal; (5) the method of result release into the patient portal: manual versus automatic release; and (6) the effects of hospital health information technology system on patient quality outcomes. Conclusions The timing of the release of test results emerged as a particularly important topic. In some countries, the policy context may motivate immediate release of most tests directly into patient portals. However, our findings aim to make policy makers, health administrators, and other stakeholders aware of factors to consider when making decisions about the timing of result release. This review is sensitive to the characteristics of patient populations and portal technology and can inform result release framework policies. The findings are timely, as patient portals have become more common internationally.

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Section: Comparison With Other Literaturementioning

confidence: 99%

Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review

Petrovskaya,

Karpman,

Schilling

et al. 2023

J Med Internet Res

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“…For example, the results of a study of 418 individuals with cancer in the US show that they prefer to receive imaging results as soon as possible from their physician over the phone than from a patient portal� 37 The value of receiving their results online is only recognized when study participants had to wait longer for a phone call from their physician� 37 Another study, involving 4,592 participants recruited from a Dutch hospital, found that individuals would choose to wait the shortest amount of time for their radiology results online� 36 However, some participants met with their doctors to discuss the results the same day as their exam� 36 It has been suggested that the optimal embargo time takes into consideration the clinical context of the user� 13,38 Results for a fracture may be released immediately, whereas complex oncological cases may be best suited for an embargo period or may be communicated to users by the physician before releasing results on a portal� 13,39,40 A tailored approach for the timing of the release of reports can be achieved in many ways, such as selecting certain physicians (e�g�, oncologists) or allowing users to choose based on their preferences� 39 As artificial intelligence (AI) and clinical decision support tools become more mainstream in imaging departments, they may be used to detect which results should be immediately released or if an embargo period may be more appropriate� 39 Results of a survey of 31 academic radiology institutions revealed that the average embargo period before the release of radiology reports in the US is 4 days� 41 As mentioned previously, Saskatchewan and Alberta provide immediate access to medical imaging results on their provincial portals� 29,32…”

Section: Considerationsmentioning

confidence: 99%

“…Standard radiology reports are written for clinicians who understand medical language and abbreviations� 12,13 The terms used by radiologists may not be well understood by individuals reading their radiology reports� 12,13 Unlike laboratory results (e�g�, blood tests), radiology reports do not have normal ranges for individuals to reference� Individual access to results on portals requires consideration of their health literacy� 12 The use of lay language when results are intended to be shared on a patient portal can help increase an individual's understanding of their health information� 6,8,43,45 It has been suggested that separate, user-friendly summaries can be shared on portals� 43 It may also be helpful to direct users to reliable web sources, such as consumer health vocabularies for information through hyperlinks on reports� 13,39 Other recommendations to help mitigate confusion include providing results in the appropriate context (e�g�, spine disc desiccation that is expected for the individual's age) 46 and working with local patient groups to develop simplified terminology for reports� 47 Structured reporting templates that are disease-specific have been developed by some groups. 40 However, it is recognized that standardizing and simplifying radiology reports requires considerable effort, especially when considering different cultures and languages� 13 A patient-centred radiology report (PACERR) prototype for prostate MRI was developed by relevant experts in health, medical imaging, engineering, and research� 48 The development of the template was informed by interviews with experts and individuals undergoing prostate MRI� 48 Another tool developed to facilitate patient-friendly reporting in radiology is Patient-Oriented Radiology Reporter (PORTER)� 49 PORTER is a lay-language glossary of frequently used terms applied to MRI exams of the knee� 49 AI and natural language processing could potentially be used to improve an individual's understanding of electronic health record content in the future� 13 For example, dedicated text-processing tools can help simplify terms� 13…”

Section: Radiology Reports With Exam Imagesmentioning

confidence: 99%

Individuals’ Access to Medical Imaging Results via Patient Portals

CADTH¹

2023

cjht

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Patient portals allow users to access, manage, and share their health information online. Patient portals are available in 6 provinces: Alberta, British Columbia, Saskatchewan, Ontario, Prince Edward Island, and Quebec. Patient portals in Canada are implemented at the provincial, regional, or clinic level of the health care system, and vary in the health data and features that are shared with users. Medical imaging reports are shared on portals in Alberta, Ontario, Quebec, and Saskatchewan. In Saskatchewan and Alberta, reports are available immediately, whereas Quebec has a 30-day embargo period. Ontario has an intention to enable patient portals to share medical images from provincial diagnostic imaging repositories in the future. A tailored approach may be considered when timing the release of medical imaging results due to concerns related to patient anxiety, especially for individuals waiting for diagnostic results of potentially life-threatening or serious conditions. Radiologists can use lay language in their reports and provide users with reliable sources of information to increase understanding of complex results. They may develop or take advantage of existing patient-friendly templates for sharing results on portals.

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“…Although many patients claim that they prefer early access to health care information, a minority of patients reportedly choose to access patient portals (20), possibly reflective in part of patient demographic characteristics and levels of technologic sophistication. Physicians have not been swamped with undesired phone calls as a result of early access to health information, possibly because of the widespread availability and use of online medical resources and references (21).…”

Section: Mezrich Et Almentioning

confidence: 99%