Patient-Friendly Test Results and Patient-Initiated Messaging Among Adult Outpatients

Patients have access to test results but often struggle with interpretation due to limited context. Helping patients understand their results is essential for engagement and may reduce unnecessary messages requesting explanation.

To test the hypothesis that releasing test results in a patient-friendly educational format would reduce rates of patient-initiated messaging.

This quality improvement study using an interrupted time series design with preintervention and postintervention evaluation was performed at a single academic medical center that implemented patient-friendly presentation of test results through a patient portal for results with the highest message volumes, including basic metabolic panel, comprehensive metabolic panel, complete blood cell count, thyroid panel or thyrotropin level, urine microalbumin tests, and selected microbial, antibody, and polymerase chain reaction (PCR) tests. Participants included adults who received outpatient test results via a patient portal from January 1 to December 31, 2024.

Educational format messaging.

The primary outcome was the proportion of results reviewed by patients followed by a patient-initiated message within 24 hours of result release. An interrupted time series was performed to estimate the association of releasing results with the new educational format with messaging. Fitted models were stratified by whether results were ordered in primary care or flagged as abnormal.

A total of 829 902 results were reviewed by 205 139 patients (mean [SD] age, 51.0 [17.8] years; 130 284 [63.5%] female). After introducing educational messaging, nonsignificant decreases in weekly messages (mean [SD], 2769.2 [451.7] vs 2754.0 [529.6]; P = .92) and the proportion of results with a patient-initiated message within 24 hours (87 038 of 497 651 [17.5%] vs 57 585 of 332 251 [17.3%]; P = .22) were observed. When stratified by tests ordered through primary care, a statistically significant decrease was observed in messaging (average marginal effect, -0.8% [95% CI, -1.2% to -0.5%]; P < .001). Messaging was increased for microbial, antibody, and PCR tests ordered outside primary care (average marginal effect, 2.1% [95% CI, 1.0% to 3.1%]; P < .001).

In this quality improvement study in which test results were released in a patient-friendly educational format, no clinically meaningful change in patient messaging was observed. As organizations navigate information transparency and growing message volumes, it is essential to develop, implement, and study approaches to support information needs without impacting clinical workflow.