JMIR Publications

ABSTRACT

Background:

The number of people with chronic diseases and the subsequent pressure on healthcare is increasing. eHealth technology for diagnostic testing can contribute to more efficient healthcare and a lower workload.

Objective:

This systematic review examines the available methods for direct online access for patients to diagnostic testing and results in the absence of a health care professional.

Methods:

PubMed, Embase, Web of Sciences, Cochrane Library, Emcare, and Academic Search Premier were searched in August 2019. Included studies focused on direct patient access to (a) online triage leading to diagnostic testing, (b) self-sampling or -testing, or (c) digitally communicating results. Thirty-nine studies were included. Quality was assessed using the Mixed Methods Appraisal Tool.

Results:

Majority of studies had a quantitative descriptive design and discussed a combination of services. The diagnostic test services focused mainly sexual transmitted infections. Overall, the usage was high for online triage (50% who used the triage booked an appointment), for self-sampling or –testing kits (83%), and for the result service (85%). The acceptability of the services was high, with 81% preferring home-based over clinic-based testing. There was a high rate of follow-up testing or treatment after a positive test (93%).

Conclusions:

Results show that direct access to testing and result services was positively evaluated and led to high rates of follow-up treatment. More research on the cost-effectiveness is needed, and to determine the potential for other diseases. Direct access to diagnostic testing can potentially lower the workload in primary care and, simultaneously, the threshold for testing.