title: Direct Release of Test Results to Patients Increases Patient Engagement and Utilization of Care.
abstract: An important focus for meaningful use criteria is to engage patients in their care by allowing them online access to their health information, including test results. There has been little evaluation of such initiatives. Using a mixed methods analysis of electronic health record data, surveys, and qualitative interviews, we examined the impact of allowing patients to view their test results via patient portal in one large health system. Quantitative data were collected for new users and all users of the patient portal. Qualitative interviews occurred with patients who had received an HbA1c or abnormal Pap result. Survey participants were active patient portal users. Our main measures were patient portal usage, factors associated with viewing test results and utilizing care, and patient and provider experiences with patient portal and direct release. Usage data show 80% of all patient portal users viewed test results during the year. Of survey respondents, 82.7% noted test results to be a very useful feature and 70% agreed that patient portal has made their provider more accessible to them. Interviewed patients reported feeling they should have direct access to test results and identified the ability to monitor results over time and prepare prior to communicating with a provider as benefits. In interviews, both patients and physicians reported instances of test results leading to unnecessary patient anxiety. Both groups noted the benefits of results released with provider interpretation. Quantitative data showed patient utilization to increase with viewing test results online, but this effect is mitigated when results are manually released by physicians. Our findings demonstrate that patient portal access to test results was highly valued by patients and appeared to increase patient engagement. However, it may lead to patient anxiety and increase rates of patient visits. We discuss how such unintended consequences can be addressed and larger implications for meaningful use criteria.
authors.affiliation: RAND Corporation, Arlington, Virginia, and Boston, Massachusetts, United States of America.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pillemer
authors.affiliation: RAND Corporation, Arlington, Virginia, and Boston, Massachusetts, United States of America.
authors.forename: Rebecca Anhang
authors.initials: RA
authors.lastname: Price
authors.affiliation: UPMC Health System, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Paone
authors.affiliation: University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America.|UPMC Health System, Pittsburgh, Pennsylvania, United States of America.
authors.forename: G Daniel
authors.initials: GD
authors.lastname: Martich
authors.affiliation: University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Steve
authors.initials: S
authors.lastname: Albert
authors.affiliation: University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Leila
authors.initials: L
authors.lastname: Haidari
authors.affiliation: UPMC Health System, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Glenn
authors.initials: G
authors.lastname: Updike
authors.affiliation: RAND Corporation, Arlington, Virginia, and Boston, Massachusetts, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Rudin
authors.affiliation: University of Nevada, Las Vegas, United States of America.
authors.forename: Darren
authors.initials: D
authors.lastname: Liu
authors.affiliation: RAND Corporation, Arlington, Virginia, and Boston, Massachusetts, United States of America.|Harvard Medical School, Boston, Massachusetts, United States of America.|Beth Israel-Deaconess Medical Center, Boston, Massachusetts, United States of America.
authors.forename: Ateev
authors.initials: A
authors.lastname: Mehrotra
mesh_terms: D022126:Access to Information; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D033283:Patient Access to Records; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014584:User-Computer Interface