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Optimizing Electronic Release of Imaging Results through an Online Patient Portal
Sean A Woolen1, Ella A Kazerooni1, Scott D Steenburg1
1From the Departments of Radiology (S.A.W., E.A.K., M.S.D.), Biostatistics (B.N., T.M.), Patient and Family Centered Care (A.W., S.C., M.A.), and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, B2-A209P, Ann Arbor, MI 48109; Michigan Radiology Quality Collaborative, Ann Arbor, Mich (S.A.W., E.A.K., M.S.D.); Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Ind (S.D.S., N.B.L., M.J.G., M.V.K., L.M.L.); and Department of Patient and Family Experience, Beaumont Health, Royal Oak, Mich (K.P.).
Abstract:
Purpose To determine an optimal embargo period preceding release of radiologic test results to an online patient portal. Materials and Methods This prospective discrete choice conjoint survey with modified orthogonal design was administered to patients by trained interviewers at four outpatient sites and two institutions from December 2016 to February 2018. Three preferences for receiving imaging results associated with a possible or known cancer diagnosis were evaluated: delay in receipt of results (1, 3, or 14 days), method of receipt (online portal, physician's office, or phone), and condition of receipt (before, at the same time as, or after health care provider). Preferences (hereafter, referred to as utilities) were derived from parameter estimates (β) of multinomial regression stratified according to study participant and choice set. Results Among 464 screened participants, the response and completion rates were 90.5% (420 of 464) and 99.5% (418 of 420), respectively. Participants preferred faster receipt of results (P < .001) from their physician (P < .001) over the telephone (P < .001). Each day of delay decreased preference by 13 percentage points. Participants preferred immediate receipt of results through an online portal (utility, -.57) if made to wait more than 6 days to get results in the office and more than 11 days to get results by telephone. Compared with receiving results in their physician's office on day 7 (utility, -.60), participants preferred immediate release through the online portal without physician involvement if followed by a telephone call within 6 days (utility, -0.49) or an office visit within 2 days (utility, -.53). Older participants preferred physician-directed communication (P < .001). Conclusion The optimal embargo period preceding release of results through an online portal depends on the timing of traditional telephone- and office-based styles of communication. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Arenson et al in this issue.
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