Optimizing Electronic Release of Imaging Results through an Online Patient Portal

Abstract

To determine an optimal embargo period preceding release of radiologic test results to an online patient portal. Materials and Methods: This prospective discrete choice conjoint survey with modified orthogonal design was administered to patients by trained interviewers at four outpatient sites and two institutions from December 2016 to February 2018. Three preferences for receiving imaging results associated with a possible or known cancer diagnosis were evaluated: delay in receipt of results (1, 3, or 14 days), method of receipt (online portal, physician's office, or phone), and condition of receipt (before, at the same time as, or after health care provider). Preferences (hereafter, referred to as utilities) were derived from parameter estimates (b) of multinomial regression stratified according to study participant and choice set. Results: Among 464 screened participants, the response and completion rates were 90.5% (420 of 464) and 99.5% (418 of 420), respectively. Participants preferred faster receipt of results (P , .001) from their physician (P , .001) over the telephone (P , .001). Each day of delay decreased preference by 13 percentage points. Participants preferred immediate receipt of results through an online portal (utility, 2.57) if made to wait more than 6 days to get results in the office and more than 11 days to get results by telephone. Compared with receiving results in their physician's office on day 7 (utility, 2.60), participants preferred immediate release through the online portal without physician involvement if followed by a telephone call within 6 days (utility, 20.49) or an office visit within 2 days (utility, 2.53). Older participants preferred physician-directed communication (P , .001). Conclusion: The optimal embargo period preceding release of results through an online portal depends on the timing of traditional telephone-and office-based styles of communication.

21st Century Cures Act, an Information Technology-Led Organizational Initiative

“…Should this information be released to the patient before the physician has had a chance to review test results and pathology reports with the patient? In a survey of 464 patients, Woolen and colleagues found that patients “prefer to receive imaging results associated with a cancer diagnosis as soon as possible, from their physician, and over the telephone” [ 18 ]. We now hold pathology reports with a cancer diagnosis for 3 days, allowing time for the clinician to contact the patient.…”

Patient preferences for health information technologies: a systematic review

“…In one study, patients' preferred direct physician communication particularly for the return of abnormal biopsy results (85) though other studies reported participant indifference to communication method (81,101) and one study reported preference for return of biopsy results via the telephone rather than in-person (102). As waiting time for in-person care increased, patients became more willing to accept electronic communication regarding health information (54,55,70,85). Patients also expressed preferences for different modalities and functionalities of HIT based on the information being communicated (e.g., preference for text message vs. email) (87,(98)(99)(100).…”

Building a Better Online Portal for Patients to Obtain Radiologic Results

“…Woolen and colleagues (1) commented that patients preferred communication with their physicians rather than with the radiologist and others have published similar conclusions (8). However, some patients might like the option to contact the radiologist in certain circumstances or when they are having difficulty reaching their physician.…”

“…I n this issue of Radiology, Woolen et al (1) describe several important findings related to patients' communication with their doctors and how quickly they receive imaging results. This study is important because of the controversies surrounding the release of imaging reports with and without referring physician control.…”