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电子发布病理和放射学结果给患者:肿瘤学家的意见和经验。

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

机构信息

Stanford University School of Medicine, Stanford, CA

Stanford University School of Medicine, Stanford, CA.

出版信息

J Oncol Pract. 2016 Aug;12(8):e792-9. doi: 10.1200/JOP.2016.011098. Epub 2016 Jul 5.

Abstract

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.

摘要

目的

为患者提供快速获取其病历内容的电子访问途径,这已成为一种新兴标准。尽管患者对此类服务的调查结果通常表示支持,但由于缺乏针对癌症等潜在危及生命情况的经验数据,这种做法在肿瘤学家中仍存在争议。我们报告了肿瘤学家对患者可能潜在指示疾病进展的放射学和病理学结果的电子访问的看法。

方法

在对肿瘤学家进行调查的四个月前,通过安全门户为患者在线提供放射学/病理学报告的最终结果,在提供结果后的 7 天内保持锁定状态,以便临床医生有时间与患者一起审查和交流结果。采用混合方法评估医生对这一变化的态度和经验。

结果

对 129 名肿瘤学家进行了调查,其中 82 名(64%)做出了回应。只有略多于半数(54%)的受访者认为,对于在与医生讨论之前已经收到正常放射学/病理学结果的患者来说,发布报告对他们是有些许或非常有益的,但 87%的人表示,在与医生讨论之前,患者收到异常结果是有些许或非常有害的。49%的人报告称,发布报告对他们与患者的沟通产生了有些许或非常负面的影响。

结论

近一半的肿瘤学家报告称,共享数字放射学和病理学记录对他们与患者的沟通产生了负面影响。在类似的癌症患者群体中进行患者调查将补充医生的观点。需要努力在如何及时以最佳方式传达此类结果方面,在肿瘤学家和患者之间达成共识。

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Radiology reporting: attitudes of referring physicians.放射学报告:转诊医生的态度
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