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More than two-thirds of patients report viewing their test results in a portal before hearing from a provider, but how well they understand them is tied to their digital literacy, according to a study published online Aug. 18 in JAMA Network Open.
Jemar R. Bather, Ph.D., from the NYU School of Global Public Health in New York City, and colleagues assessed whether a patient’s probability of accessing test results through a patient portal before hearing about the results from their health care practitioner, and understanding them, varies by sociodemographic characteristics, health status, patient-centered communication, or digital health literacy and engagement. The analysis included responses from 4,982 participants in the 2024 Health Information National Trends Survey.
The researchers found that 68.6 percent of respondents viewed immediately released test results before hearing from their health care practitioner. Among these viewers, 6.6 percent rated their understanding of what the immediately released test results showed and what the results meant for their care as poor, 26.8 percent rated their understanding as fairly well, 31.7 percent as well, and 34.9 percent as very well. Older age, female sex, higher income, greater number of chronic health conditions, higher digital literacy, and greater health-related social media use were associated with viewing immediately released test results. A poor comprehension rating among those who did view early was associated with living in the Midwest or South and experiencing medical care discrimination. A lower prevalence of poor comprehension was seen among those experiencing greater patient-centered communication and higher digital literacy.
“Health systems give you your data, but that does not mean that they put a lot of effort into making the information easy to understand on your own,” coauthor José Pagán, Ph.D., also from the NYU School of Global Public Health, said in a statement. “Health systems and online patient portal developers should look for innovative ways to improve how they communicate — for instance, using AI to summarize test results in plain language and provide easy means for follow-up questions.”
One author disclosed ties to Companion IQ.
Having immediate access to pertinent health information can support patient engagement, but access doesn’t necessarily equal understanding. The problem lies within inequitable patient portal access among certain patient populations. Research shows that Black and Hispanic patients were offered and accessed patient portals at significantly lower rates than white individuals. Additionally, Black patients can often wait longer than a day to receive replies from their care teams after sending a portal message, often due to under-resourced clinics. These disparities highlight the importance of considering digital access alongside digital literacy.
With this in mind, clinicians shouldn’t assume that a patient who can log into a portal necessarily understands what they’re seeing.
For many patients, medical terminology, reference ranges, abnormal flags, and isolated numbers can be difficult to understand. The study’s findings reveal that digital health literacy was strongly associated with understanding results. Clinicians (and their supporting staff) should assess whether patients know where to find results, what they mean, and when to expect follow-up.
Below are some practical steps clinicians can take to better support patients in understanding test results:
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