JMIR Publications

ABSTRACT

Background:

A frequently used feature of electronic patient portals is viewing test results. Research on the use and effects of patient portals is abundant and offers evidence and roadmaps to help portal implementers make policy and practice decisions. In contrast, no comparable comprehensive summary of research exists addressing direct release of and patient access to test results.

Objective:

The purpose of this scoping review was to analyze and synthesize published research focused on patient and healthcare provider perspectives on direct release of laboratory, imaging, and radiology results to patients via online portals.

Methods:

PRISMA guidelines were followed. Searches were conducted in CINAHL, MEDLINE, and other databases. Citations were screened in Covidence in two stages (title/abstract and full text screening) using inclusion and exclusion criteria. We included studies on direct release of, and patient access to, test results via patient portals. Primary studies focused on patient and healthcare provider perspectives on patient online access to laboratory and imaging results were included. An updated search captured the period up to August 2023. Our review included 27 articles: 20 examining patient views, 3 examining provider views, and 4 examining both patient and provider views. Data extraction and inductive data analysis were informed by sensitizing concepts from sociomaterial perspectives, and 15 themes were generated.

Results:

Patient perspectives (n=24 papers) are synthesized in 9 themes: 1. Patterns of Use and Patient Characteristics; 2. Emotional Response When Viewing the Results and Uncertainty About Their Implications; 3. Understanding Test Results; 4. Preferences for Mode and Timing of Result Release; 5. Information Seeking and Patients’ Actions Motivated by Viewing Results Online; 6. Contemplating Change in Behaviour and Managing Own Health; 7. Benefits of Accessing Test Results Online; 8. Limitations of Accessing Test Results Online; 9. Suggestions for Portal Improvement. Healthcare provider perspectives (n=7 papers) are synthetized in 6 themes: 1. Providers’ View of Benefits of Patient Access to Results via Portal; 2. Effects on Healthcare Provider Workload; 3. Concerns About Patient Anxiety; 4. Timing of Result Release into the Patient Portal; 5. The Method of Result Release into the Patient Portal: Manual Versus Automatic Release; 6. Patient Portal as a Component of the Hospital Health Information Technology System and its Correlation with Patient Quality Outcomes.

Conclusions:

The timing of releasing test results emerged as a particularly important topic. The policy context in some countries may motivate immediate release of most tests directly into patient portals. However, our findings aim to make policy makers, health administrators, and other stakeholders aware of factors to consider when making decisions about the timing of result release. This review is sensitive to characteristics of patient populations and portal technology and can inform result release framework policies. The findings are timely as patient portals become more common internationally.