TOPLINE:
After implementation of the 21st Century Cures Act in 2021, 75% of cancer test results were viewed by patients first compared with 37% in 2017, a trends analysis shows.
METHODOLOGY:
- The Cures Act mandated immediate release of all medical test results to patients through electronic portals, which means patients that may learn test results before their clinicians do.
- However, immediate access to test results can present challenges for patients, especially when results indicate bad news or could be misinterpreted.
- In the current analysis, researchers assessed how patients and clinicians viewed cancer test results before and after Cures Act implementation.
- The research team identified patients with at least one laboratory, radiology, or pathology result through the electronic health record (her) and electronic patient portal at UT Southwestern Medical Center Dallas (Epic MyChart) between 2017 and 2022.
- The team then evaluated the time from test result availability in the EHR and patient portal to providers and patients viewing those results.
TAKEAWAY:
- The analysis included the 5.57 million test results released to 44,419 patients — 69% (3.86 million) before the Cures Act and 31% (1.71 million) after. Patients viewed 2.7 million (49%) results overall — of these, 64% (1.73 million) were viewed before the Cures Act and 36% (0.97 million) after.
- The median time from a result posting in the EHR to patients reviewing in the portal decreased from 77.0 hours before the Cures Act to 6.4 hours after the Cures Act. The median time from results being released in the portal to patients reviewing decreased from 6.5 hours before the Cures Act to 5.6 hours after.
- The proportion of test results that patients viewed before their ordering clinicians saw them increased significantly from 37% in 2017 to 75% in 2022, with the greatest increase for radiology results.
- The data also indicate that patients viewed a greater proportion of radiology and pathology results (both 64%) than laboratory results (47%).
IN PRACTICE:
"After the Cures Act, 75% of test results were viewed by patients before the ordering clinician, almost double the views in 2017," the authors wrote. "How patients with cancer receive test results has implications for practice quality," the study authors explained, noting that although "m ost patients prefer to receive test results immediately through the portal," patients also "report increased anxiety when receiving abnormal results this way."
SOURCE:
The study, with first author Sheena Bhalla, MD, Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, was published online on November 30 in JAMA Oncology.
LIMITATIONS:
Limitations include the single-center design; a lack of clinical context for tests ordered, such as whether a pathology result conveyed an initial cancer diagnosis; and not accounting for personnel aside from the ordering clinician viewing the results.
DISCLOSURES:
The study had no specific funding. Bhalla reported receiving personal fees from AstraZeneca, Merus, Mirati, and Takeda.
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