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 "The benefits of improving patient access to their own medical
information are fairly clear: patient empowerment and engagement in
their own health care, and an improved trust and sense of
partnership with their healthcare provider," Dr. Daniel Miller, an
assistant professor of dermatology at the University of Minnesota in
Minneapolis, told Reuters Health by email.
Both studies, however, also suggest that giving people online access
to their own lab reports - in these studies, skin biopsy results -
might come with risks that won't be entirely clear until more people
are getting their test results this way, said Miller, who wrote an
editorial accompanying the studies in JAMA Dermatology.
"The concerns (the studies) raise include unnecessary confusion,
worry and anxiety for patients, when they are left trying to
interpret complex medical information on their own," he said.
Clinicians in most fields of medicine, dermatology among them, are
trying to find ways to effectively communicate with patients on
their smartphones and online, and more patients say they want these
convenient options, experts say. The trouble is, even as providers
embrace new technology, they've struggled to shed the technical
medical jargon that can make it hard for patients to understand what
they're reading.
Pathology reports for skin biopsies are just one example of this
problem.
"Historically, dermatopathology reports have been crafted to speak
to the medical expert who performed the biopsy, with the expectation
that they will provide context and practical understanding when they
then contact the patient," Miller said. "Pathologists may need to
change the manner in which they craft reports if this document will
ultimately go straight to patients."
One of the two studies surveyed 160 dermatologists about sharing
pathology reports online. Overall, 6 in 10 thought this could
improve patient understanding of their results and also increase
doctor-patient communication.
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However, 7 in 10 doctors thought reading reports online would worry
patients. One in four also thought they would benefit from special
training to alter how they write reports with patients in mind.
"The physicians who responded to our survey perceived that reading
their pathology reports increased patient worry and confusion," said
the senior author of this study, Dr. Joann Elmore of the David
Geffen School of Medicine at the University of California, Los
Angeles.
"However, despite their concerns for potential negative effects,
their overall perception of such access was positive," Elmore said
by email.
The second study surveyed 225 patients to see how well they
understood the diagnosis after reading a pathology report online.
Half of the participants said they used an online patient portal to
access health records at least once a month, and another 19% checked
weekly.
When researchers asked patients to answer a multiple-choice question
about their diagnosis, however, only 12% circled the correct answer
and almost half of them left it blank.
"Misunderstandings around pathology reports can definitely create
anxiety for patients that may require additional conversations with
their physician to resolve," said senior author of the second study,
Dr. Alice Watson MD, director of quality and safety for the
dermatology department at Brigham and Women's in Boston.
"Our practice is to provide follow-up to patient regarding all
biopsy results, benign or malignant, by letter or phone, so the
pathology report is not the only information the patient receives,"
Watson said by email.
SOURCE: https://bit.ly/2OUpOhn , https://bit.ly/2USAG3e and https://bit.ly/39xzu9m
JAMA Dermatology, online January 29, 2020.
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