You get a message that a test result is available in your online patient portal. Do you look at it right away, or do you wait to hear from your health care provider?
That may depend on several factors, including your digital literacy, income, age, and experience communicating with doctors and nurses, according to a new study led by researchers at NYU School of Global Public Health. The findings, published in JAMA Network Open , suggest that there is room for improvement in how health information is presented to patients.
The 21st Century Cures Act requires that electronic health information—including test results like labwork and imaging—be released to patients as soon as the results are available. As a result, many see their results before their provider.
"The Cures Act has restructured the traditional pathway between the release of a test result to a patient-clinician discussion," said Jemar Bather, assistant professor of biostatistics at NYU School of Global Public Health and the study's lead author. "We wanted to understand whether a patient's probability of accessing test results—and understanding of them—varies based on sociodemographic characteristics, health status, patient-centered communication, and digital health literacy."
The researchers analyzed data from the 2024 Health Information National Trends survey, a representative sample of US adults collected by the National Institutes of Health. A total of 4,982 respondents who had access to their electronic medical records and received a test result in the past year were included, which can be generalized to represent nearly 175,000,000 US adults.
More than two-thirds of adults (68.6 percent) reported viewing their test results before hearing from a provider. Those who immediately viewed results were more likely to be older and female, and have a higher income, multiple chronic health conditions, higher digital literacy, and greater use of health-related social media.
In addition, comprehension of test results varied. Among those who immediately viewed results, 6.6 percent said they had a poor understanding, 26.8 percent understood the results fairly well, 31.7 percent understood them well, and 34.9 percent understood the results very well. Those who reported having the lowest understanding of their test results were more likely to be from the Midwest or South and had experienced discrimination in medical care.
In contrast, people with higher digital literacy had a better understanding of their medical test results, as did those who experienced better patient-centered communication—for instance, feeling that health care professionals explain things in a way they can understand and involve them in decision making.
"Health systems give you your data, but that does not mean that they put a lot of effort into making the information easy to understand on your own," said study author José Pagán, professor and chair of the Department of Public Health Policy and Management at NYU School of Global Public Health. "Health systems and online patient portal developers should look for innovative ways to improve how they communicate—for instance, using AI to summarize test results in plain language and provide easy means for follow-up questions."
"While the Cures Act's goal of expanded patient access is being realized, a subset of patients who view their results before being contacted by their health care provider is having difficulty understanding what they see. Improving patient-centered communication may help in closing this comprehension gap," noted Bather.
In addition to Bather and Pagán, study authors include Melody Goodman of NYU School of Global Public Health, Zoe Lindenfeld of Rutgers University, Karen Fortuna of the Geisel School of Medicine at Dartmouth, and Guilherme Del Fiol and Kimberly Kaphingst of the University of Utah.
