JMIR Publications

ABSTRACT

Background:

The immediate release of test results to patients through online portals, mandated by the 21st Century Cures Act, has increased transparency but also heightened patient anxiety, particularly in the context of cancer diagnosis and monitoring. Patients often experience uncertainty and lack of control when results are released without context, leading to increased psychological distress.

Objective:

This paper proposes an anticipatory guidance framework to help clinicians and health systems mitigate anxiety and improve patient experience during the process of receiving test results through patient portals.

Methods:

We conducted a patient-partnered case study and literature review to identify key factors contributing to test-related anxiety. We developed a five-step anticipatory guidance conversation guide for clinicians to use at the time of test ordering. We include recommendations for health systems and EHR vendors, to include educating clinicians and patients, implementing customizable portal notifications, and integrating anticipatory guidance into routine practice.

Results:

Anticipatory guidance can reduce patient anxiety by addressing threat, uncertainty, and lack of control associated with receiving unfiltered test results. The framework empowers patients to make informed choices about when and how to receive results and provides clinicians with a structured approach to support patients throughout the process. Early evidence suggests that this approach improves patient satisfaction and reduces unintended psychological harm.

Conclusions:

While immediate access to test results is beneficial for transparency, it can increase patient anxiety if not managed appropriately. Anticipatory guidance offers a practical and evidence-based solution to help patients navigate the emotional challenges of receiving test results, ensuring that the process of care does not exacerbate patient distress