Electronic Patient Portals as a Modality for Returning Reclassified Genetic Test Results

Most reclassified genetic test results are clinically inactionable and burdensome for healthcare providers to return to patients. The feasibility of using electronic patient portals (e.g., MyChart) to return reclassified results remains unclear.

Patient and provider initiated MyChart actions were obtained from MyChart data and matched to patient demographic and clinical information using unique patient medical record numbers. Data on who (patient or provider) sent and read these messages and when (date and time) were collected for clinically actionable and inactionable reclassifications.

Among 801 patients with 828 reclassified variants in cancer susceptibility genes, 551 had an active MyChart account at the time of reclassification. Patients with active MyChart accounts were less likely to be Hispanic (p < 0.001) compared to other ethnic groups. Of these, 302 (55%) were notified about 308 reclassified results (307 inactionable and 1 actionable) via MyChart messages, and 80% (244/302) read the message within a median time of 3.6 h.

We find that it is feasible to return reclassified results via electronic patient portals for most patients, but alternative modalities are still necessary. Unidirectional, low-touch modalities of recontact can be used to efficiently return the increasing number of inactionable reclassified results.