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皮肤科病理学家对患者在线获取病理检验结果报告的体验和看法。

Dermatopathologists' Experience With and Perceptions of Patient Online Access to Pathologic Test Result Reports.

机构信息

Department of Biostatistics, University of Washington, Seattle.

Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle.

出版信息

JAMA Dermatol. 2020 Mar 1;156(3):320-324. doi: 10.1001/jamadermatol.2019.4194.

Abstract

IMPORTANCE

Many patients presently have access to their pathologic test result reports via online patient portals, yet little is known about pathologists' perspective on this topic.

OBJECTIVE

To examine dermatopathologists' experience and perceptions of patient online access to pathology reports.

DESIGN, SETTING, AND PARTICIPANTS: A survey of 160 dermatopathologists currently practicing in the United States who are board certified and/or fellowship trained in dermatopathology was conducted between July 15, 2018, and September 23, 2019. Those who reported interpreting skin biopsies of melanocytic lesions within the previous year and expected to continue interpreting them for the next 2 years were included.

MAIN OUTCOMES AND MEASURES

Dermatopathologists' demographic and clinical characteristics, experiences with patient online access to pathologic test result reports, potential behaviors and reactions to patient online access to those reports, and effects on patients who read their pathologic test result reports online.

RESULTS

Of the 160 participating dermatopathologists from the 226 eligible for participation (71% response rate), 107 were men (67%); mean (SD) age was 49 (9.7) years (range, 34-77 years). Ninety-one participants (57%) reported that patients have contacted them directly about pathologic test reports they had written. Some participants noted that they would decrease their use of abbreviations and/or specialized terminology (57 [36%]), change the way they describe lesions suspicious for cancer (29 [18%]), and need specialized training in communicating with patients (39 [24%]) if patients were reading their reports. Most respondents perceived that patient understanding would increase (97 [61%]) and the quality of patient-physician communication would increase (98 [61%]) owing to the availability of online reports. Slightly higher proportions perceived increased patient worry (114 [71%]) and confusion (116 [73%]). However, on balance, most participants (114 [71%]) agreed that making pathologic test result reports available to patients online is a good idea.

CONCLUSIONS AND RELEVANCE

Dermatopathologists in this survey study perceived both positive and negative consequences of patient online access to pathologic test result reports written by the respondents. Most participants believe that making pathologic test result reports available to patients online is a good idea; however, they also report concerns about patient worry and confusion increasing as a result. Further research regarding best practices and the effect on both patients and clinicians is warranted.

摘要

重要性

目前许多患者可通过在线患者门户获取其病理检验结果报告,但对于病理学家对此主题的看法却知之甚少。

目的

调查皮肤科病理学家对患者在线获取病理报告的经验和看法。

设计、地点和参与者:对美国目前从事皮肤科病理工作的 160 名皮肤科病理学家进行了一项调查,这些病理学家均为美国病理学家委员会认证的或经过皮肤科病理专科培训的。入组标准为:在过去一年中曾解读过黑素细胞病变皮肤活检,且预计在未来 2 年内仍将继续解读此类报告。

主要结局和测量指标

皮肤科病理学家的人口统计学和临床特征、对患者在线获取病理检验结果报告的经验、对患者在线获取这些报告的潜在行为和反应,以及对在线阅读病理检验结果报告的患者的影响。

结果

在 226 名符合参与条件的参与者中,有 160 名(71%的回复率)参与了该项研究,其中 107 名为男性(67%);平均(SD)年龄为 49(9.7)岁(范围,34-77 岁)。91 名参与者(57%)报告称,患者曾直接联系他们询问他们所写的病理检验报告。一些参与者表示,如果患者阅读他们的报告,他们将减少使用缩写和/或专业术语(57[36%])、改变描述疑似癌症病变的方式(29[18%])以及需要专门培训来与患者沟通(39[24%])。大多数受访者认为,由于在线报告的可用性,患者的理解程度会提高(97[61%]),医患沟通的质量也会提高(98[61%])。略高比例的人认为患者的担忧(114[71%])和困惑(116[73%])会增加。然而,总的来说,大多数参与者(114[71%])认为让患者在线获取病理检验结果报告是一个好主意。

结论和相关性

在这项调查研究中,皮肤科病理学家认为患者在线获取受访者所写的病理检验结果报告既有积极影响,也有消极影响。大多数参与者认为让患者在线获取病理检验结果报告是一个好主意;然而,他们也报告称,担心患者的担忧和困惑会因此增加。有必要进一步研究最佳实践及其对患者和临床医生的影响。

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