Surgical Providers' Perceptions of the Patient Portal: Before and After the 21st Century Cures Act

In April 2021, the Information Blocking Rule (IBR) of the 21st Century Cures Act went into effect giving patients immediate access to notes, radiology reports, lab results, and surgical pathology. We aimed to examine changes in surgical providers' perceptions of patient portal usage before and after its implementation.

We administered a 37-question survey prior to the implementation of the IBR and a 39-question follow-up survey 3 mo later. The survey was sent to all surgeons, advanced practice providers, and clinic nurses in our surgical department.

The response rate to pre surveys and post surveys was 33.7% and 30.7%, respectively. Providers' preference for communication via the patient portal (compared to phone or in person) regarding lab, radiology, or pathology results remained similar. While there was an increase in messages received from patients, there was no difference in the self-reported time spent on the electronic health record (EHR). Prior to the implementation of the blocking rule, 75.8% of providers believed that the portal increased workload which decreased to 57.4% on our follow-up survey. About one-third of providers screened positive for burnout before (32%) which decreased slightly (27.4%).

Although 43.9% of providers reported the Cures Act had changed their practice, there was no difference in self-reported EHR usage, preferred method of interaction with patients, overall workload, or burnout. Initial concerns regarding the IBR's effect on job satisfaction, patient anxiety, and quality of care had lessened. Further exploration into how patients having immediate access to their EHRs has changed surgical practice is needed.