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J Am Med Inform Assoc. 2018 Apr 1;25(4):440-446. doi: 10.1093/jamia/ocx140.

Patient perceptions of receiving test results via online portals: a mixed-methods study.

Author information

Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Department of Biomedical Informatics, University of Utah, and VA Salt Lake City Health Care System, Salt Lake City, UT, USA.
Center for Healthcare Quality and Safety, School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA.



Online portals provide patients with access to their test results, but it is unknown how patients use these tools to manage results and what information is available to promote understanding. We conducted a mixed-methods study to explore patients' experiences and preferences when accessing their test results via portals.

Materials and Methods:

We conducted 95 interviews (13 semistructured and 82 structured) with adults who viewed a test result in their portal between April 2015 and September 2016 at 4 large outpatient clinics in Houston, Texas. Semistructured interviews were coded using content analysis and transformed into quantitative data and integrated with the structured interview data. Descriptive statistics were used to summarize the structured data.


Nearly two-thirds (63%) did not receive any explanatory information or test result interpretation at the time they received the result, and 46% conducted online searches for further information about their result. Patients who received an abnormal result were more likely to experience negative emotions (56% vs 21%; Pā€‰=ā€‰.003) and more likely to call their physician (44% vs 15%; Pā€‰=ā€‰.002) compared with those who received normal results.


Study findings suggest that online portals are not currently designed to present test results to patients in a meaningful way. Patients experienced negative emotions often with abnormal results, but sometimes even with normal results. Simply providing access via portals is insufficient; additional strategies are needed to help patients interpret and manage their online test results.


Given the absence of national guidance, our findings could help strengthen policy and practice in this area and inform innovations that promote patient understanding of test results.

[Indexed for MEDLINE]
Free PMC Article

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