BUSI 505 Week 6 Discussion Board Forum 3 Example

Discussion Board Forum 3: Patient Portals, Information Access and Immediate Release of Results

BUSI 505 Healthcare Informatics, Discussion Board Forum 3

Thread by [Student Name]

The health system, its policy debate and the classmates are composites; the textbooks, Scripture and the peer-reviewed sources cited are real.

At our health system, oncologists recently asked leadership to delay the portal release of pathology and imaging results until a clinician had reviewed them. Their concern is real. A patient who reads "adenocarcinoma" in a pathology report at midnight, alone and without context, may be frightened and confused, and may search the internet for answers that are outdated or simply wrong for their situation. Before the 21st Century Cures Act's information blocking rules, our system held such results for several days so clinicians could call first. Now results generally post as soon as they are final, and leaders must decide whether to seek exceptions, educate patients or change how results are presented. The decision is not purely clinical; it involves federal rules, patient rights, clinician workload and the trust patients place in the health system, and leaders will face criticism whichever way they choose.

Nelson and Staggers (2014) describe consumer health informatics as the use of technology to give patients access to their own information and a role in their own care, and Braunstein (2014) describes patient portals as one of the main tools for that engagement. In this view, a test result belongs to the patient as much as to the clinician, and the informatics question is not whether patients should see it but how to make seeing it helpful rather than harmful. That framing also matches the purpose of the federal rules, which aim to end practices that kept patients from their own information for convenience or habit.

Evidence from two large surveys suggests most patients want immediate access, even for bad news, though not every patient experiences it the same way. Steitz et al. (2023) surveyed 8,139 patients and care partners from four academic health systems, all of whom had opened results in the portal. Nearly all respondents, close to 96%, wanted results released right away, and that preference held almost as strongly among people whose results were abnormal. Only 7.5% reported feeling more anxious because they saw results before a clinician reached them, though that share was 16.5% among those with abnormal results compared with 5.0% among those with normal ones. Richwine et al. (2026), using a 2024 national survey of more than 6,000 adults who received results through a portal, found that 58% viewed results before hearing from their clinician, yet only 28% reported being given a choice about how results would be communicated, and only 66% said they understood the results they viewed.

These findings suggest that blanket delays would override the wishes of most patients, while the current approach leaves too many patients without a choice or an explanation. The oncologists' concern is valid for a minority of patients and a minority of results, which argues for targeted solutions rather than a system-wide hold. I would recommend three steps. First, offer patients a choice when tests are ordered, especially for biopsies and cancer imaging, about whether they want results immediately or after a conversation. Second, attach plain-language explanations to common results and let clinicians add a brief note to sensitive ones, even a single sentence about next steps. Third, schedule follow-up calls or visits for expected high-stakes results so the conversation happens promptly. Leaders should track how many patients choose each option, how many urgent messages follow sensitive results and patient-reported worry, and revisit the policy after six months. The goal is not to keep information from patients but to make sure no patient meets frightening news alone.

Proverbs observes that anxiety in a person's heart weighs them down, but a good word makes them glad (English Standard Version Bible, 2001/2016, Proverbs 12:25). Immediate access respects patients' right to their information; the good word that accompanies it is what turns a frightening number into understanding.

Reply to Sophie

Sophie, you argued that immediate release has shifted work onto clinicians, who now field anxious messages about results they have not yet reviewed, and that this burden should count in any policy. Your point deserves attention because a policy that is good for patients but unsustainable for clinicians will eventually erode. You are right that the workload is real, and it lands most heavily on specialties that deliver serious news, such as oncology, urology and radiology. Ignoring that burden would risk burnout and resentment toward a policy that most patients support. Blancaflor et al. (2026) surveyed patients and urologists about the immediate release of prostate biopsy results. Before biopsy, 63.2% of patients preferred immediate release, and 84.1% viewed their results in the portal before their follow-up visit. Patients' understanding was fairly high, with 77.1% finding results easy to understand, and it rose to 92.1% after counseling, which shows the value of the conversation that follows the result. Yet fewer than 10% of the 58 New England urologists surveyed preferred immediate release, and their dissatisfaction was significantly associated with more frequent patient messages and calls. Steitz et al. (2023) found that most patients wanted immediate access even for abnormal results, which suggests the solution is to support clinicians rather than restrict patients. The two studies together describe a genuine conflict of preferences, and leaders must design around it rather than declaring one side right. Nelson and Staggers (2014) note that consumer access tools change clinical workflows, and Braunstein (2014) emphasizes that organizations must redesign processes around new information flows rather than expecting clinicians to absorb the extra work on top of full schedules. Practical supports could include nurse navigators who call patients after high-stakes results post, templated plain-language explanations for common findings and scheduling rules that place follow-up appointments within a day or two of expected results. These changes cost money, but they may also reduce the number of urgent messages clinicians receive. A nurse navigator who calls a patient within hours of a biopsy result posting can answer the most common questions, arrange the next appointment and escalate only what truly requires a physician. Over time, the navigator's notes would also show which explanations patients need most, guiding the templates. The Proverbs say that a word spoken at the right time is good (English Standard Version Bible, 2001/2016, Proverbs 15:23), and support staff who reach patients promptly can provide that timely word without adding to physicians' workload. Would your organization fund a navigator for biopsy results as a pilot and track message volume before and after? That data would show whether the investment pays for itself in clinician time, and patient satisfaction scores would show whether it improves the experience of receiving difficult news.

Reply to Andre

Andre, you pointed out that access means little if patients cannot understand what they are reading, and you asked how health systems can close that gap. Equity is at stake here as much as communication, since the patients who struggle most to understand results are often those already facing barriers to care. The evidence supports your concern. Richwine et al. (2026), drawing on a nationally representative 2024 survey, found that only 66% of patients who received portal results said they understood them, and that viewing results was strongly associated with education, digital literacy and whether a clinician had encouraged portal use. That pattern suggests that immediate release, for all its benefits, may help some patients far more than others, widening existing gaps in health literacy. Patients who are older, have less formal education or speak a language other than English may be the least able to interpret a laboratory value or a radiology impression, yet they often have the most to gain from understanding their health. Steitz et al. (2023) also found that worry was more common among patients whose results were abnormal, which is exactly when understanding matters most and when a confusing report can do the most harm. Nelson and Staggers (2014) describe health literacy and usability as central to consumer informatics, and Braunstein (2014) notes that patient-facing tools must be designed for people with varied skills, languages and levels of comfort with technology. A health system that takes this gap seriously could respond in several practical ways: plain-language summaries generated for common laboratory and imaging results, explanations in patients' preferred languages, links to short videos and clear instructions about whom to contact with questions, including after hours. Clinicians could also encourage portal use during visits, since encouragement was associated with much higher use; in the national survey, 70% of encouraged patients viewed their results, compared with 24% of those who were not encouraged. Measuring understanding, for example through brief portal surveys after results are viewed, would show whether these changes help. Results should be broken down by age, language and education so that leaders can see whether gaps are narrowing or widening. Nehemiah records that the readers of the law read it clearly and gave its sense so that the people understood (English Standard Version Bible, 2001/2016, Nehemiah 8:8), and health systems that release results have a similar duty to help patients understand them, not merely to deliver them. Would your organization consider adding a one-sentence plain-language summary to its most common results? Starting with the twenty most frequently ordered tests would reach a large share of patients quickly, and clinicians and patient advisors could review the wording together to make sure it is accurate and reassuring without being misleading.

References

Blancaflor, A., Ochsner, A., Glebocki, R., Westrick, L., Braunagel, T., Connolly, W., Bhatt, V., McKinnon, S., Avellino, G., Eaton, S., Tompkins, A., & Hyams, E. (2026). Immediate release of prostate biopsy results: Perspectives from patients and providers. Urology, 213, 96-100. https://doi.org/10.1016/j.urology.2026.04.029

Braunstein, M. L. (2014). Contemporary health informatics. AHIMA Press.

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Nelson, R., & Staggers, N. (2014). Health informatics: An interprofessional approach. Elsevier Mosby.

Richwine, C., Steitz, B., & Everson, J. (2026). Patient-reported experiences with viewing and understanding test results in patient portals: Cross-sectional survey analysis. Journal of Medical Internet Research, 28, e94098. https://doi.org/10.2196/94098

Steitz, B. D., Turer, R. W., Lin, C.-T., MacDonald, S., Salmi, L., Wright, A., Lehmann, C. U., Langford, K., McDonald, S. A., Reese, T. J., Sternberg, P., Chen, Q., Rosenbloom, S. T., & DesRoches, C. M. (2023). Perspectives of patients about immediate access to test results through an online patient portal. JAMA Network Open, 6(3), e233572. https://doi.org/10.1001/jamanetworkopen.2023.3572