Oncology patient and provider preferences regarding rapid radiology result release to online portals.

Abstract

1544 Background: Spurred by changes in legislation and technology, rapid patient access to medical results has never been higher. Many health systems now release results of radiology tests within 24 hours of completion, meaning patients may see results before being able to discuss them with the ordering provider. Generally, surveys have demonstrated that patients are in favor of rapid result availability, but research on rapid result release to oncology patients with distinct concerns is scant. Methods: Starting in February 2020, oncology providers throughout Sanford Health, a multi-site primarily rural integrated practice in the upper Midwest were invited to complete an online survey regarding their opinions on rapid result release. Starting in February 2020, oncology patients were invited to complete a similar survey. This survey was open until August 2020, when 100 patients had completed the survey; both surveys contained both categorical and narrative results. Results: Oncology providers had a generally more negative opinion of rapid radiology result release to online portals compared to patients. 65% of patients believed radiology results should be released within 24 hours of resulting; only 12% of providers shared this view. 66% of providers shared that they did not feel comfortable with patients’ ability to interpret radiology results and only 13% felt that “normal” results should be released immediately to an online portal; this number decreased to 3% when results were “abnormal”. Patient opinions on appropriate result release were impacted by test results as well. For “normal” radiology results, 50% of patients favored initial communication be via online portal without discussion with a provider; for “abnormal” results, this number decreased to 28%. 43% of patients had learned of an “abnormal” result via online portal before discussion with a provider; 66% of these patients felt that this was a positive which allowed them to process information prior to the visit; 33% felt that it created undue anxiety. 94% of providers reported having a patient contact them regarding a test result prior to a planned visit, with 60% providers sharing this happens at least once weekly. When asked what improvements could be made to the system currently in place at Sanford, 80% of providers suggested holding radiology results until direct communication with the provider can occur; only 8% of patients suggested the same intervention. Conclusions: Rapid result release is generally a patient satisfier, although oncology patients do distinguish abnormal from normal results in terms of rapid release. It is a dissatisfier for providers both due to concerns regarding patients’ ability to interpret results and due to excess work created by rapid release. Ongoing work should focus on ways to allow patients to access resources to make medical results more interpretable if reviewed prior to provider visits.