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

## TL;DR

A study found that providing patient-friendly test results through a portal slightly reduced patient messages for primary care tests but had mixed effects on other tests.

## Contribution

This study evaluates the impact of patient-friendly educational test results on patient messaging behavior in outpatient settings.

## Key findings

- Patient-initiated messaging decreased by 0.8% for primary care tests after introducing patient-friendly formats.
- Messaging increased by 2.1% for microbial and PCR tests ordered outside primary care.
- Overall messaging rates showed no clinically meaningful change despite the new format.

## Abstract

Among adult patients, is the release of test results via patient portal in a patient-friendly educational format associated with a decrease in patient-initiated messaging?

In this quality improvement study including 205 139 patients who reviewed 829 902 test results during 2024, patient-initiated messaging decreased by 15 messages per week after the introduction of a patient-friendly educational format for test results. A statistically significant decrease of 0.8% in messages sent after reviewing results for tests ordered in primary care was observed.

These findings suggest that generalized patient-friendly educational materials may support patients reviewing their results but may not promote significant changes in patient messaging behavior.

This quality improvement study assesses whether patient-friendly educational information could reduce the weekly rates and proportions of patient-initiated messaging after review of test results via an online patient portal.

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.