Direct Access for Patients to Diagnostic Testing and Results Using eHealth: Systematic Review on eHealth and Diagnostics

Abstract

Background The number of people with chronic diseases and the subsequent pressure on health care is increasing. eHealth technology for diagnostic testing can contribute to more efficient health care and lower workload. Objective This systematic review examines the available methods for direct web-based access for patients to diagnostic testing and results in the absence of a health care professional in primary care. Methods We searched the PubMed, Embase, Web of Sciences, Cochrane Library, Emcare, and Academic Search Premier databases in August 2019 and updated in July 2021. The included studies focused on direct patient access to web-based triage leading to diagnostic testing, self-sampling or testing, or web-based communication of test results. A total of 45 studies were included. The quality was assessed using the Mixed Methods Appraisal Tool. Results Most studies had a quantitative descriptive design and discussed a combination of services. Diagnostic test services mainly focused on sexually transmitted infections. Overall, the use was high for web-based triage (3046/5000, >50%, who used a triage booked a test), for self-sampling or self-testing kits (83%), and the result service (85%). The acceptability of the test services was high, with 81% preferring home-based testing over clinic-based testing. There was a high rate of follow-up testing or treatment after a positive test (93%). Conclusions The results show that direct access to testing and result services had high use rates, was positively evaluated, and led to high rates of follow-up treatment. More research on cost-effectiveness is needed to determine the potential for other diseases. Direct access to diagnostic testing can lower the threshold for testing in users, potentially increase efficiency, and lower the workload in primary care.

“Technology Proficiency” in Medical Education: Worthiness for Worldwide Wonderful Competency and Sophistication

“… 13 (c) Clinical acceptance: Further studies are required for leading technologies to clinical acceptance. 15 (d) Effectiveness: Stronger primary research on the effectiveness of contact tracing technologies is needed. 27 (e) Confidence: Authors confidence in the effect estimates is limited.…”

“…More studies needed for (i) the use of these as screening tools (ii) to clearly define the ideal population for the use of these systems (iii) formulation of specific guidance on the management of device-detected disease (iv) evidence for policy making decisions by health departments in the future (v) testing to meet regulatory standards. Supportive of ‘Technology proficiency’ Versluis et al 2022 15 Mainly focused on sexually transmitted infections. Examination of direct web-based access methods for diagnostic testing and results, in situations of non-availability of health care professional in primary care.…”

The Usability of Homelab, a Digital Self-service at a Dutch General Practice, for Diagnostic Tests: Pilot Study With a Questionnaire

“…With such services, patients can order a diagnostic test online, for example, for COVID-19, perform the test at home or a facility, and view the result online. A recent review [17] showed that most of the included web-based diagnostic services (which were operated independently by health care professionals) were positively evaluated and found very acceptable by patients, but most of the services focused on sexually transmitted infections, and direct access to diagnostic services for other diseases was rare.…”

“…To our knowledge, this is the first web-based diagnostic service completely integrated into the web-based environment of the GP, and no research has been performed into the type of users and the frequency of use of Homelab. Although services are available where patients can order diagnostic tests themselves without a GP [17], a service where this is integrated in the GP environment is new. Homelab has several advantages for the patient.…”

Materiality and the mediating roles of eHealth: A qualitative study and comparison of three cases

“…An eHealth solution can belong to one of these domains or contain elements from several domains. 3 Research on eHealth has focussed on changed roles for healthcare professionals, [4][5][6] the importance of alignment with care processes, [7][8][9] impact of staff turnover, 10 increased workload 11 and/or decreased workload, [12][13][14] changes in workflow [15][16][17][18] and changes in professional values. 5,7,19 Consequently, previous research shows that eHealth solutions influence the way healthcare professionals conduct their work and provide care.…”