Electronic Release of Pathology and Radiology Results to Patients: Opinions and Experiences of Oncologists.

PURPOSE There is an emerging standard to provide patients rapid electronic access to elements of their medical records. Although surveys of patients generally support it, this practice is controversial among oncologists, because few empiric data are available for scenarios of potentially life-threatening conditions like cancer. We report the views of oncologists about patient electronic access to radiology and pathology results that could potentially indicate disease progression. METHODS Four months before oncologists were surveyed, final results of radiology/pathology reports were routinely made available to patients online through a secure portal after a 7-day, hold to provide clinicians time to review and communicate results with the patients. Mixed methods were used to assess physician attitudes and experiences toward this change. RESULTS One hundred twenty-nine oncologists were surveyed, and 82 (64%) responded. A small majority (54%) responded that the release of reports was somewhat or very beneficial for patients who received normal radiology/pathology results before discussion with a physician, but 87% said it was somewhat or very harmful for patients to receive abnormal results before discussion. Forty-nine percent reported that release of reports had a somewhat or very negative impact on communication with their patients. CONCLUSION Almost half of oncologists reported that sharing digital radiology and pathology records had a negative impact on their communication with patients. Patient surveys in similar cancer populations would complement the physician perspective. Efforts are needed to improve consensus among oncologists and patients on how to best communicate such results in a timely fashion.

[1]  Hardeep Singh,et al.  Patient access to medical records and healthcare outcomes: a systematic review , 2014, J. Am. Medical Informatics Assoc..

[2]  P. Harris,et al.  Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support , 2009, J. Biomed. Informatics.

[3]  K. Devers,et al.  Qualitative data analysis for health services research: developing taxonomy, themes, and theory. , 2007, Health services research.

[4]  A. J. Johnson,et al.  Access to radiologic reports via a patient portal: clinical simulations to investigate patient preferences. , 2012, Journal of the American College of Radiology : JACR.

[5]  I. Dey Qualitative Data Analysis: A User Friendly Guide for Social Scientists , 1993 .

[6]  Jocelyn Cornwell,et al.  Engaging patients in health care: an empirical study of the role of engagement on attitudes and action. , 2009, Patient education and counseling.

[7]  J. Gruman,et al.  From patient education to patient engagement: implications for the field of patient education. , 2010, Patient education and counseling.

[8]  Chen-Tan Lin,et al.  Review Paper: The Effects of Promoting Patient Access to Medical Records: A Review , 2003, J. Am. Medical Informatics Assoc..

[9]  Andrew Georgiou,et al.  Emergency Physicians’ Views of Direct Notification of Laboratory and Radiology Results to Patients Using the Internet: A Multisite Survey , 2015, Journal of medical Internet research.

[10]  Joann G Elmore,et al.  Inviting Patients to Read Their Doctors' Notes: A Quasi-experimental Study and a Look Ahead , 2011, Annals of Internal Medicine.

[11]  A. Thompson,et al.  The meaning of patient involvement and participation in health care consultations: a taxonomy. , 2007, Social science & medicine.

[12]  Andrew Georgiou,et al.  Releasing test results directly to patients: A multisite survey of physician perspectives. , 2015, Patient education and counseling.

[13]  Jim Bellows,et al.  Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions? , 2007, The Journal of ambulatory care management.

[14]  Susan M Schneider,et al.  Nurse and physician perspectives on patients with cancer having online access to their laboratory results. , 2011, Oncology nursing forum.

[15]  C. Pope,et al.  Qualitative Research in Health Care , 1999 .

[16]  V. Entwistle,et al.  Patient involvement in treatment decision-making: the case for a broader conceptual framework. , 2006, Patient education and counseling.