Nearly 7 in 10 patients view their test results online before a clinician contacts them to explain, according to a study published Aug. 18 in JAMA Network Open.
The study drew on 4,982 respondents to the 2024 “Health Information National Trends Survey,” a nationally representative sample weighted to about 175 million U.S. adults who had been offered online access to their records and had a medical test in the past year. Researchers at New York City’s NYU School of Global Public Health led the analysis.
Of those adults, 68.6% saw their results before hearing from a healthcare practitioner.
Comprehension varied among the early viewers. About 6.6% said they understood their results poorly, while 26.8% understood them “fairly well,” 31.7% “well” and 34.9% “very well.”
The 21st Century Cures Act’s information-blocking rules have required immediate release of most test results since 2021. The Cures Act’s “behavioral goal of expanded patient access is being realized,” the authors wrote, but a subset of patients who viewed results before being contacted “reported poor understanding of what they saw.”
Early viewing skewed toward older, female and higher-income patients and those with more chronic conditions and greater digital literacy. Patients 65 and older were 19% more likely to view results early than those 18 to 34, and women were 14% more likely than men. Among early viewers, poor comprehension was 69% more prevalent for patients who reported experiencing discrimination in medical care, and less common among those who reported patient-centered communication with their clinicians.
The authors described the analysis as exploratory and noted the survey could not identify respondents’ health systems, leaving system-level differences in how results are released unaccounted for.
The findings sharpen a tension present since the immediate-release rules took hold. Emailed and portal-posted results have stirred patient panic when technical findings reach patients before a physician can add context, and researchers have long warned that portals can be a source of stress.
