Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review (2024)

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Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review (1)

Author(s):

Olga Petrovskaya , RN, PhD 1 , ,

Albina Karpman , RN, MN 2 ,

Joanna Schilling , RN, MN 1 ,

Simran Singh , RN, MN 3 ,

Larissa Wegren , RN, MN 4 ,

Vera Caine , RN, PhD 1 ,

Elizabeth Kusi-Appiah , RN, MN 3 ,

Willow Geen 1

Editor(s):

Amaryllis Mavragani

Other contributor(s):

Elske Ammenwerth (Reviewer),

Melita Avdagovska (Reviewer),

Tracie Risling (Reviewer),

Matthew D Krasowski (Reviewer)

Publication date (Electronic): 19 October 2023

Journal: Journal of Medical Internet Research

Publisher: JMIR Publications

Keywords: patient portal, web portal, MyChart, electronic health records, personal health records, patient access to records, laboratory tests, radiology reports, diagnostic imaging, laboratory test results, result release, embargo, the Cures Act

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      Abstract

      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.

      Related collections

      JMIR Publications

      Most cited references68

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      PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

      Adrian Aldcroft, Chantelle Garritty, Simon Lewin (2018)

      Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.

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        Interventions to increase patient portal use in vulnerable populations: a systematic review

        Lisa Grossman, Ruth M. Masterson Creber, Natalie C Benda (2019)

        More than 100 studies document disparities in patient portal use among vulnerable populations. Developing and testing strategies to reduce disparities in use is essential to ensure portals benefit all populations. To systematically review the impact of interventions designed to: (1) increase portal use or predictors of use in vulnerable patient populations, or (2) reduce disparities in use. A librarian searched Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Reviews for studies published before September 1, 2018. Two reviewers independently selected English-language research articles that evaluated any interventions designed to impact an eligible outcome. One reviewer extracted data and categorized interventions, then another assessed accuracy. Two reviewers independently assessed risk of bias. Out of 18 included studies, 15 (83%) assessed an intervention's impact on portal use, 7 (39%) on predictors of use, and 1 (6%) on disparities in use. Most interventions studied focused on the individual (13 out of 26, 50%), as opposed to facilitating conditions, such as the tool, task, environment, or organization (SEIPS model). Twelve studies (67%) reported a statistically significant increase in portal use or predictors of use, or reduced disparities. Five studies (28%) had high or unclear risk of bias. Individually focused interventions have the most evidence for increasing portal use in vulnerable populations. Interventions affecting other system elements (tool, task, environment, organization) have not been sufficiently studied to draw conclusions. Given the well-established evidence for disparities in use and the limited research on effective interventions, research should move beyond identifying disparities to systematically addressing them at multiple levels.

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        Internet use by the public to search for health-related information.

        Khalid AlGhamdi, Noura A Moussa (2012)

        The use of the Internet to search for health-related information (HRI) has become a common practice worldwide. Our literature review failed to find any evidence of previous studies on this topic from Saudi Arabia. To determine the public use of the Internet in Saudi Arabia to search for HRI and to evaluate patients' perceptions of the quality of the information available on the Internet compared to that provided by their health care providers. A self-administered questionnaire about Internet use to search for HRI was distributed randomly to male and female outpatients and visitors attending a public University Hospital in Riyadh, Saudi Arabia from January to May 2010. A Chi-squared test was used to assess the association between different categorical variables. Multiple logistic regression was used to relate the use of the Internet to search for HRI with various socio-demographic variables. The questionnaire response was 80.1%, with completion of 801 of the 1000 distributed questionnaires; 50% (400/801) of respondents were males. The mean age of respondents was 32±11 years. The majority of respondents used the Internet in general (87.8%), and 58.4% of them (363/622) used the Internet to search for HRI. The majority stated a doctor was their primary source of HRI (89.3%, 654/732). This practice was considered useful by 84.2%, and the main reason behind it was sheer curiosity (92.7%, 418/451). Other reasons included not getting enough information from their doctor (58.5%, 227/413) and not trusting the information given by their doctor (28.2%, 101/443). Forty-four percent (205/466) searched for HRI before coming to the clinic; 72.5% of those discussed the information with their doctors and 71.7% (119/166) of those who did so believed that this positively affected their relationship with their doctor. Searching the Internet for health information was observed more frequently among the 30-39 year age group (OR=2.0, 95% CI 1.1-3.7), females (OR=3.8, 95% CI 2.3-6.4), individuals with university or higher education (OR=1.7, 95% CI 1.1-2.8), employed individuals (OR=2.7, 95% CI 1.4-4.9) and high income groups (OR=2.8, 95% CI 1.5-5.1). A proportion of the public searches the Internet to obtain HRI for various reasons, which could have consequences on their health and relationship with their doctors. Therefore, doctors should be aware of the health information available online to help guide patients to reliable websites. Health authorities should also be aware of the issue to offer regulations and solutions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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          Author and article information

          Contributors

          Olga Petrovskaya:

          ORCID: https://orcid.org/0000-0001-5929-3598

          School of NursingUniversity of VictoriaPO Box 1700 STN CSCVictoria, BC, V8W 2Y2Canada1 250 472 4607olgap@uvic.ca

          Journal

          Journal ID (nlm-ta): J Med Internet Res

          Journal ID (iso-abbrev): J Med Internet Res

          Journal ID (publisher-id): JMIR

          Title: Journal of Medical Internet Research

          Publisher: JMIR Publications (Toronto, Canada )

          ISSN (Print): 1439-4456

          ISSN (Electronic): 1438-8871

          Publication date Collection: 2023

          Publication date (Electronic): 19 October 2023

          Volume: 25

          Electronic Location Identifier: e43765

          Affiliations

          [1 ] School of Nursing University of Victoria Victoria, BC Canada

          [2 ] Faculty of Nursing MacEwan University Edmonton, AB Canada

          [3 ] Faculty of Nursing University of Alberta Edmonton, AB Canada

          [4 ] South Health Campus, Women's Health Calgary, AB Canada

          Author notes

          Corresponding Author: Olga Petrovskaya olgap@ 123456uvic.ca

          Author information
          Article

          Publisher ID: v25i1e43765

          DOI: 10.2196/43765

          PMC ID: 10623227

          PubMed ID: 37856174

          SO-VID: ed9c1b7c-ac93-43f6-b8ef-1cb53f3f5715

          Copyright © ©Olga Petrovskaya, Albina Karpman, Joanna Schilling, Simran Singh, Larissa Wegren, Vera Caine, Elizabeth Kusi-Appiah, Willow Geen. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 19.10.2023.

          License:

          This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

          History

          Date received : 24 October 2022

          Date revision requested : 14 November 2022

          Date revision received : 1 September 2023

          Date accepted : 19 September 2023

          Categories

          Subject: Review

          Subject: Review


          ScienceOpen disciplines: Medicine

          Keywords: patient portal,web portal,mychart,electronic health records,personal health records,patient access to records,laboratory tests,radiology reports,diagnostic imaging,laboratory test results,result release,embargo,the cures act

          Data availability:

          ScienceOpen disciplines: Medicine

          Keywords: patient portal, web portal, mychart, electronic health records, personal health records, patient access to records, laboratory tests, radiology reports, diagnostic imaging, laboratory test results, result release, embargo, the cures act

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          Patient and Health Care Provider Perspectives on Patient Access to Test Results via Web Portals: Scoping Review (2024)
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