A friend, I’ll call her Linda, recently told me about her experience retrieving results from her doctor’s patient portal — a way for patients to view test results and other parts of their medical charts online. When she read through her chest X-ray report, she noticed that the concluding statement was “normal chest,” but that the text of the report mentioned a small lung nodule. She messaged her physician, who humbly admitted that he had not seen that inconsistency, and proceeded to order some follow-up testing.
Fortunately, the evaluation did not reveal anything serious, but my friend was startled by what might have gone terribly wrong if the nodule had been malignant and she had not been vigilant about checking her own test results. By virtue of using the patient portal, Linda became an engaged partner in her medical care.
There are many ways to be a well-informed, assertive patient, an approach that clinicians today are increasingly embracing. The patient portal takes this to another level — by taking you right into your health record.
Not all medical offices offer patient portals, but they are gaining popularity. At the very least, portals allow patients to view their own test results, although sometimes health-care providers will need to “release” results once they have seen them before patients can view them.
Other portals allow patients to view results as soon as they are posted. I prefer this type for the reasons illustrated in Linda’s story — it is more transparent and allows for a better provider-patient partnership. Many patient portals have evolved to near complete transparency, allowing patients full access to their charts, including test results, problem and medication lists, and even provider progress notes. These shared notes may help patients better remember and follow the specific treatment regimens their providers have recommended.
What do you do if you find an inaccuracy or worrisome test result? Online portals allow patients to message the provider or other members of the care team. This system is win-win — it is more efficient for patients, bypassing labyrinthine medical office phone systems with long hold times, and easier for providers to fit returning messages into the work day.
To some, this level of participation may seem awkward, as if a boundary were being overstepped. I like to think of it as akin to having work done on your home. If you hired a contractor to renovate a room, would you leave town and say, “If I don’t hear from you, I’ll assume everything came out fine"? Probably not. Many of us, even if we lack skill or expertise in construction, would examine the contractor’s work, and ask questions if something did not seem quite right. We should certainly treat work on our own bodies with a comparable level of scrutiny.
Many doctors and other health-care providers welcome a more transparent, collaborative relationship with patients. In my own primary-care practice, I receive hundreds of results per week in my electronic in-basket, many of them copies of tests ordered by specialists my patients also visit. We have a rigorous system of results review, but I welcome another set of eyes on these data and inquiries from my patients about any of them. Shared progress notes may help with complex treatment regimens, which patients can revisit and review when needed.
If your medical office has a patient portal, take advantage of it. It is easy to sign up — you usually just need an email address, along with a username and password for portal access. Many portals even have mobile apps, for easy access anytime, anywhere.
This new technology provides an opportunity to be a true member of your own health-care team.
Jeffrey Millstein, M.D., is a primary-care physician at Penn Internal Medicine Woodbury Heights.