Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
J Am Med Inform Assoc. 2018 Apr 1;25(4):440-446. doi: 10.1093/jamia/ocx140.
Online portals provide patients with access to their test results, but it is unknown how patients use these tools to manage results and what information is available to promote understanding. We conducted a mixed-methods study to explore patients' experiences and preferences when accessing their test results via portals.
We conducted 95 interviews (13 semistructured and 82 structured) with adults who viewed a test result in their portal between April 2015 and September 2016 at 4 large outpatient clinics in Houston, Texas. Semistructured interviews were coded using content analysis and transformed into quantitative data and integrated with the structured interview data. Descriptive statistics were used to summarize the structured data.
Nearly two-thirds (63%) did not receive any explanatory information or test result interpretation at the time they received the result, and 46% conducted online searches for further information about their result. Patients who received an abnormal result were more likely to experience negative emotions (56% vs 21%; P = .003) and more likely to call their physician (44% vs 15%; P = .002) compared with those who received normal results.
Study findings suggest that online portals are not currently designed to present test results to patients in a meaningful way. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results. Simply providing access via portals is insufficient; additional strategies are needed to help patients interpret and manage their online test results.
Given the absence of national guidance, our findings could help strengthen policy and practice in this area and inform innovations that promote patient understanding of test results.
在线门户为患者提供了获取检测结果的途径,但尚不清楚患者如何使用这些工具来管理结果,以及有哪些信息可用于促进理解。我们开展了一项混合方法研究,以探究患者通过门户获取检测结果时的体验和偏好。
我们对 2015 年 4 月至 2016 年 9 月期间在德克萨斯州休斯顿的 4 家大型门诊诊所查看门户中检测结果的成年人进行了 95 次访谈(13 次半结构化访谈和 82 次结构化访谈)。对半结构化访谈进行了内容分析编码,并转化为定量数据,并与结构化访谈数据进行整合。使用描述性统计方法对结构化数据进行了总结。
近三分之二(63%)的患者在收到检测结果时没有收到任何解释性信息或检测结果解读,46%的患者上网搜索了更多有关其检测结果的信息。与收到正常结果的患者相比,收到异常结果的患者更可能体验到负面情绪(56%比 21%;P = .003),更可能给医生打电话(44%比 15%;P = .002)。
研究结果表明,在线门户目前并没有以有意义的方式向患者呈现检测结果。患者在收到异常结果时通常会感到负面情绪,但有时甚至在收到正常结果时也会感到负面情绪。仅仅通过门户提供访问途径是不够的;需要采取额外的策略来帮助患者解释和管理其在线检测结果。
鉴于目前缺乏国家指导,我们的研究结果可以帮助加强这一领域的政策和实践,并为促进患者对检测结果的理解提供创新思路。