Patient portals: An engagement tool or source of patient stress? 6 notes

Patient portals offer an appealing way to engage patients in their own medical care, but some industry experts wonder whether lab results released without clinical interpretation cause confusion for patients and more work for physicians, according to an analysis by The Washington Post.

Here are six notes on how lab results released on patient portals are changing medical care.

1. Today, between 15 and 30 percent of patients access lab results on patient portals, which comprise an online overview of their medical record. By contrast, a typical patient awaiting lab results a decade ago would receive a call from their physician or schedule an in-person follow-up appointment. During these meetings, a physician would present the patient with their lab results and interpret the findings.

2. Many healthcare stakeholders — such as providers and policymakers — have suggested patient portals will foster patient engagement and improve patient safety by delivering information to patients more quickly. About a year ago, Danville, Pa.-based Geisinger, for example, began making most of its lab results available to patients within four hours of being finalized.

3. However, since a lab result may be posted online before a patient's physician has had a chance to view it, the patient may be the first to learn of an abnormal result. A recent study cited by The Washington Post found almost two-thirds of patients who accessed lab results via a patient portal did not receive explanatory information, leading roughly half to seek out information online, without clinical guidance.

4. These lab results, released without a clinical explanation or interpretation, may lead to confusion among patients, particularly for those with low health literacy skills. Some of this confusion arises from how lab results are often reported in the format the physician would see them, despite the fact the typical patient doesn't have the training to read these tests.

5. As an example, The Washington Post spoke with Laura Devitt, a patient who received an abnormal result after routine blood tests and discovered the finding on her patient portal. She initially waited for her physician to call her with an explanation of her results, but after two days, she chose to reach out herself. Following a second round of testing, her physician determined her results were normal.

"I think getting [test results] online is great," she told The Washington Post. "But if it's concerning, there should be some sort of note from a doctor."

6. Ms. Devitt's experiences mirror a 2016 study cited by The Washington Post, which found while patient portals helped to engage patients in their healthcare, it also tended to increase patient anxiety and led to more physician visits.

"There is just not enough information about how [patient portals] should be done right," Hardeep Singh, MD, an associate professor at the Houston-based Baylor College of Medicine, told The Washington Post. "There are unintended consequences for not thinking it through."

To access The Washington Post's analysis, click here.

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