“You’ve Got Mail”—Receiving Bad News Through a Patient Portal

Abstract

This Viewpoint discusses the impersonalization of delivering bad news to patients through a patient portal rather than in person.

Contemporary Trends in Reviewing Test Results Through the Electronic Patient Portal Among Patients With Cancer

“…While intended to improve information sharing, questions have arisen about consequences for patient well-being and communication. For instance, patients may now learn of a new, recurrent, or progressing cancer before discussion with clinicians . This study assessed contemporary patterns of patient and clinician viewing of test results before and after Cures Act implementation.…”

The doctor, the patient, and the computer

“…The Office of the National Coordinator for Health Information Technology (ONC) of the USA Department of Health and Human Services, made it clear in 2021 that providers can no longer delay, block or change the release of electronic health information to patients, including their laboratory, pathology, and imaging results, as well as affiliated and clinical notes. 24 In a Viewpoint article published in 2023, 25 Bellizzi discussed the implications of delivering “bad news” to patients through a technical computer-generated report, with no human health care provider involved and readily available to explain the implications of this information, often for days. He, himself, had a diagnosis of cancer, and had a follow-up CT scan on a Thursday, the report from which the following text was posted in his portal on late Friday afternoon: “ there is a moderate-sized focus of moderate intensity uptake in the lower neck, midline and slightly to the left of midline.…”