Lit Matters 2: Immediate Test Result Access Preferred Even by Patients with Abnormal Results

Immediate online release of test results appears to match what most patients want, even when results are abnormal. Early post–Cures Act survey data show higher patient engagement, more early portal messaging, and a clear preference for transparency over delayed clinician-mediated disclosure.

Immediate Test Result Access

• Strong patient preference: Immediate release was favored by 95.7% of surveyed patients, and even among those who perceived results as abnormal, 95.3% still preferred getting them without delay.
• Abnormal result worry signal: Concern rose when patients thought a result was abnormal, with 16.5% reporting increased worry versus 5% after normal results, but that anxiety rarely changed their preference for immediate access.
• Engagement after Cures Act: Real-time portal access coincided with a 4-fold increase in patients seeing results before speaking with a clinician and a 2-fold rise in messages during the first 6 hours.
• Pre-counseling limitation: Advance counseling did not meaningfully reduce worry after result release, suggesting the main issue is not simply preparation but how patients interpret unexpected information.
• Implementation in the ED: Patient portals are now part of emergency care workflow, so after-visit summaries and expectation-setting need to anticipate that patients may see results before the team does. We get into practical communication tactics in the episode.
• Survey bias caveat: The sample came from four academic centers and likely overrepresented portal-savvy patients willing to complete surveys, but it remains some of the best current patient-preference data on this policy change.