JMIR Publications

ABSTRACT

Background:

The rapid implementation of patient portals, through which patients can view their electronic health record (EHR), creates possibilities for information exchange and communication between patients and caregivers. However, real-time disclosure of test results and clinical reports poses a source of concern.

Objective:

To examine negative experiences resulting from real-time disclosure of medical information through a patient portal.

Methods:

Data was collected over a two years period in four datasets consisting of incidents reported by caregivers, complaints of patients, patient issues at a portal-helpdesk and a survey among caregivers. Incidents, complaints, issues and answers on the survey were counted and analyzed through an iterative process of coding.

Results:

Within the chosen timeframe of two years on average 7,978 patients per month logged in to the portal at least once. The amount of negative incidents and complaints was limited. Six incidents, 4 complaints and 2,506 issues at the helpdesk concerning the patient portal were reported of which only 2, 1 and 3 cases of these respective databases concerned real-time disclosure of medical information through the patient portal. Thirty-two out of 216 caregivers reported (a) patient(s) that had (a) negative experience(s) with real-time disclosure. Most negative consequences concerned confused and anxious patients when confronted with unexpected or incomprehensible results.

Conclusions:

Real-time access through a patient portal did not substantially result in negative consequences. The negative consequences that did occur can be mitigated by adequate preparation and instruction of patients concerning the various functionalities of the patient portal, real-time disclosure of test results in particular, and can also be managed through educating caregivers about the patient portal and making adjustments in the daily practice of healthcare professionals. Clinical Trial: The Medical Research Involving Human Rights Act (WMO) did not apply to this study and therefore an official approval of this study was not required under the WMO, which was confirmed by the MREC Utrecht (protocol number 17.759/C).