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abstract
Purpose: There is an
emerging standard to provide patients rapid electronic access to
elements of their medical records. Although
surveys of patients generally support it, this
practice is controversial among oncologists, because few empiric data
are available
for scenarios of potentially life-threatening
conditions like cancer. We report the views of oncologists about patient
electronic
access to radiology and pathology results that
could potentially indicate disease progression.
Methods: Four months
before oncologists were surveyed, final results of radiology/pathology
reports were routinely made available
to patients online through a secure portal after
a 7-day, hold to provide clinicians time to review and communicate
results
with the patients. Mixed methods were used to
assess physician attitudes and experiences toward this change.
Results: One hundred
twenty-nine oncologists were surveyed, and 82 (64%) responded. A small
majority (54%) responded that the release
of reports was somewhat or very beneficial for
patients who received normal radiology/pathology results before
discussion
with a physician, but 87% said it was somewhat
or very harmful for patients to receive abnormal results before
discussion.
Forty-nine percent reported that release of
reports had a somewhat or very negative impact on communication with
their patients.
Conclusion: Almost
half of oncologists reported that sharing digital radiology and
pathology records had a negative impact on their communication
with patients. Patient surveys in similar cancer
populations would complement the physician perspective. Efforts are
needed
to improve consensus among oncologists and
patients on how to best communicate such results in a timely fashion.
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