When Patient Portals Break Bad News.

Area of Science:

• Medical Informatics
• Oncology Patient Communication
• Digital Health

Background:

• Electronic patient portals enhance patient-provider communication but pose challenges for delivering sensitive information.
• A significant portion of oncology patients access diagnoses via portals before clinical discussion.
• Traditional methods for breaking bad news emphasize in-person or telephone empathy and support.

Purpose of the Study:

• To examine the impact of electronic patient portals on the delivery of bad news in oncology.
• To provide recommendations for military healthcare providers managing sensitive information release through portals.
• To suggest system-level changes for electronic health records to better support sensitive communication.

Main Methods:

• Review of existing literature and patient communication practices regarding electronic portals.
• Analysis of patient preferences for receiving bad news.
• Formulation of practice-based and system-level recommendations for military providers and the MHS GENESIS system.

Main Results:

• Electronic portals can lead to premature access of sensitive oncology reports, potentially undermining empathetic delivery of bad news.
• Most patients prefer in-person or telephone communication for receiving serious diagnoses.
• Current electronic health record (EHR) systems may automatically release sensitive results without provider-patient discussion.

Conclusions:

• Healthcare providers must be aware of the implications of electronic portal usage on sensitive patient communication.
• Adjusting practices, such as warning patients about early result access, is crucial.
• Modifying EHR systems, like MHS GENESIS, to allow delayed release of sensitive reports post-discussion is recommended.