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Brief Report
January 29, 2020

Dermatopathologists’ Experience With and Perceptions of Patient Online Access to Pathologic Test Result Reports

Author Affiliations
  • 1Department of Biostatistics, University of Washington, Seattle
  • 2Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle
  • 3Dermatopathology Northwest, Bellevue, Washington
  • 4David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles
  • 5Pathology Associates, Clovis, California
  • 6Institut Curie, Department of Pathology, Paris Sciences and Lettres Research University, Paris, France
  • 7Faculty of Medicine, University of Paris Descartes, Paris, France
  • 8Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia
JAMA Dermatol. 2020;156(3):320-324. doi:10.1001/jamadermatol.2019.4194
Key Points

Question  What are dermatopathologists’ experiences and perceptions regarding patients having online access to pathologic test result reports?

Findings  In this survey study of 160 dermatopathologists, 57% reported that they have been contacted by patients about their pathologic test result reports. Although most respondents believe that having online access to these reports will help patient understanding of their medical issues (61%) and increase the quality of patient-physician communication (61%), most also reported concerns about increasing patient worry (71%) and confusion (73%).

Meaning  As more patients gain online access to their pathologic test result reports, it is important to consider how to optimize these reports to improve comprehension by patients and reduce potentially negative consequences.

Abstract

Importance  Many patients presently have access to their pathologic test result reports via online patient portals, yet little is known about pathologists’ perspective on this topic.

Objective  To examine dermatopathologists’ experience and perceptions of patient online access to pathology reports.

Design, Setting, and Participants  A survey of 160 dermatopathologists currently practicing in the United States who are board certified and/or fellowship trained in dermatopathology was conducted between July 15, 2018, and September 23, 2019. Those who reported interpreting skin biopsies of melanocytic lesions within the previous year and expected to continue interpreting them for the next 2 years were included.

Main Outcomes and Measures  Dermatopathologists’ demographic and clinical characteristics, experiences with patient online access to pathologic test result reports, potential behaviors and reactions to patient online access to those reports, and effects on patients who read their pathologic test result reports online.

Results  Of the 160 participating dermatopathologists from the 226 eligible for participation (71% response rate), 107 were men (67%); mean (SD) age was 49 (9.7) years (range, 34-77 years). Ninety-one participants (57%) reported that patients have contacted them directly about pathologic test reports they had written. Some participants noted that they would decrease their use of abbreviations and/or specialized terminology (57 [36%]), change the way they describe lesions suspicious for cancer (29 [18%]), and need specialized training in communicating with patients (39 [24%]) if patients were reading their reports. Most respondents perceived that patient understanding would increase (97 [61%]) and the quality of patient-physician communication would increase (98 [61%]) owing to the availability of online reports. Slightly higher proportions perceived increased patient worry (114 [71%]) and confusion (116 [73%]). However, on balance, most participants (114 [71%]) agreed that making pathologic test result reports available to patients online is a good idea.

Conclusions and Relevance  Dermatopathologists in this survey study perceived both positive and negative consequences of patient online access to pathologic test result reports written by the respondents. Most participants believe that making pathologic test result reports available to patients online is a good idea; however, they also report concerns about patient worry and confusion increasing as a result. Further research regarding best practices and the effect on both patients and clinicians is warranted.

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