Why are sensitive medical results, such as cancer diagnoses from computed tomography (CT) scans, released to patients automatically before healthcare provider review?

Balancing Automatic Release of Medical Results with Patient-Centered Communication

Healthcare organizations should flag sensitive information like cancer diagnoses in patient portals and provide patients the option to receive such information in person from their healthcare provider rather than automatically through electronic systems. 1

Current Issues with Automatic Result Release

• Patient portals that automatically release test results can lead to patients receiving sensitive diagnoses like cancer before their healthcare provider has an opportunity to discuss the findings with them 1
• This practice can cause unnecessary anxiety and distress for patients who may not have the medical context to properly interpret their results 1
• The varying preferences among patients for level of access to electronic medical records (EMRs) and healthcare staff concerns about unlimited patient access to sensitive information create challenges for healthcare organizations 1

Guidelines for Sensitive Information Management

• Healthcare organizations should develop specific procedures for releasing sensitive information to patient portals 1
• Guidelines that exist for outpatient portals should be adapted to inpatient settings to ensure consistent handling of sensitive information 1
• Sensitive information should be flagged in electronic systems with warnings that allow patients to choose whether to view the information immediately or receive it in person from a healthcare team member 1

Impact on Patient Outcomes

• Timely follow-up after positive cancer screening results is critical for reducing mortality and morbidity, but this doesn't necessitate automatic release of results before provider review 1
• The psychological impact of receiving a cancer diagnosis without proper support can negatively affect a patient's quality of life 1
• Patient anxiety and worry during the waiting period between a positive screening test and diagnostic confirmation is a significant concern that should be addressed in result communication strategies 1

Best Practices for Result Communication

• Healthcare providers should be given priority access to sensitive diagnostic information to facilitate appropriate patient communication 1
• Cancer registries and healthcare systems should have clear policies about who can access identifiable patient data and under what circumstances 1
• Physicians should be given access to data needed for management of their patients before automatic release to patients 1

Improving Patient-Provider Communication

• When discussing patient-identified information or disagreeing with patient interpretations, providers should use relationship-building communication approaches rather than dismissive responses 2
• More than one-third of cancer patients report negative communication experiences when sharing information they've found with their providers 2
• Provider prioritization of relationship-building alongside explanations can foster trust and facilitate open information exchange, supporting informed decisions 2

Implementation Strategies

• Healthcare organizations should consider implementing structured messaging systems that ensure patients receive important and relevant information in an appropriate context 1
• Patient portals should be designed with varying levels of access to sensitive information, allowing for customization based on patient preferences 1
• Training materials for patient portal use should directly address common patient concerns (e.g., information security) and healthcare staff concerns (e.g., workflow changes) 1

Common Pitfalls to Avoid

• One-size-fits-all approaches to patient portal design and training are ineffective due to varying patient preferences and abilities 1
• Automatic release of sensitive results without context can lead to misinterpretation and unnecessary anxiety 1
• Patients who are most vulnerable (e.g., those with low health literacy or who are seriously ill) are least likely to benefit from patient portals without appropriate support 1
• Avoidance of conversations about patient-identified information, discouragement of information searches, or judgmental comments by providers negatively impact patient outcomes 2

By implementing these recommendations, healthcare systems can balance the benefits of patient access to medical information with the need for appropriate context and support when delivering sensitive diagnoses like cancer.