- Healthcare organizations and medical systems need to create better patient education and provider training when implementing patient portals in oncology units, according to a new study published in the Journal of Medical Internet Research.
Doing so will support patient-provider communication and relationships in a vulnerable medical specialty, the researchers said.
Healthcare professionals have touted the necessity for transparent and easy access to patient medical records via the patient portal. Patient portal access has created new pathways for patient-provider communication, patient health literacy, and patient data access.
And while much study has gone into understanding how the new technology impacts the patient-provider relationship, most of that information relates to the primary care setting.
“Primary care patients predominantly use patient portals to view doctor’s notes, understand their condition, and to check for errors in their record,” the researchers pointed out. “Primary care patients have reported high levels of satisfaction when viewing lab results online.”
Although primary care patients report general satisfaction with patient portal use, the tool creates an entirely different situation in oncology. Providers need to be sensitive about potentially scary information or abnormal test results when treating cancer patients.
Many cancer patients report wanting their test results as soon as possible and value the patient portal for that reason, but there are still many questions left surrounding patient portal use in oncology, the researchers said.
“In contrast to typical primary care patients, cancer patients who view results on patient portals may potentially discover that their cancer has grown or metastasized,” the team explained. “This is particularly concerning as many cancer patients do not fully understand their prognosis. Moreover, patients are viewing this information at a time of heightened emotional distress, characterized by fear and uncertainty, exacerbated by the complexity of the information.”
Interviews with 60 oncology care stakeholders – 35 patients, 13 oncologists, and 12 medical informaticists – at a National Cancer Institute revealed that these players could stand to receive more information about the portal before adopting the tool.
Medical systems need to consult oncologists and medical informaticists during the implementation process, the researchers said. When healthcare organizations did not consult oncologists about the patient portal functions, providers remained in the dark about how to use the tools to enhance and supplement their patient communications.
Opinions about the patient portal as a communication tool also varied by end user. Oncologists favored the tool for communication, but medical informaticists did not necessarily see that utility, the team explained.
Patients preferred the patient portal for communication depending upon the test results being discussed.
In fact, 54 percent of patients reported that they are already receiving their test results before speaking with their oncologists. While patients did not report any major dissatisfaction with the situation, they did say that they may prefer more face-to-face communication or phone calls when discussing sensitive test results.
Providers must discuss the patient portal with patients to better understand patient expectations with the tool, the researchers stated.
“Perhaps, during an initial oncology consultation, oncologists should note that potentially threatening risk information can be available by using the portal and identify whether the portal is the patient’s preferred communication channel,” the research team suggested. “Oncologists should also recognize that their own preferred method of delivering bad news via in-person disclosures accompanied by emotional support, may need to be modified in the light of patient preferences for immediate delivery of results, even when they are abnormal.”
Ultimately, healthcare professionals need better orientation with the tool prior to full implementation into the patient experience. Providers who know more about the tool, medical test reporting, and patient views can better leverage the tool to improve patient health literacy while supporting a good rapport with patients.
“Results indicate that the portal may provide benefits, such as enabling more productive in-person appointments,” the researchers concluded. “However, education and training is necessary to inform patients and oncologists of the portal’s advantages.”