Editors: Raymond D. Aller, MD, & Dennis Winsten
In patient portals, it’s not just what you say but how you say it
March 2024—While Dr. Seuss’ assertion that “the more that you read, the more things you will know” is generally accurate, it doesn’t address the fact that how information is presented affects comprehension, a truism that is not lost on Edward Klatt, MD, who knows whereof he speaks when it comes to sharing information on patient portals.
As the general population increasingly accesses results of medical tests through portals, pathologists and clinicians need to further explore how to present information to patients electronically, says Dr. Klatt, who is professor of pathology at Mercer University Health Sciences Center, Savannah, Ga., and the author of a Journal of Pathology Informatics article on how to meaningfully communicate test results to patients (published online Nov. 8, 2023. http://dx.doi.org/10.1016/j.jpi.2023.100349).
“We can have the world’s greatest information, but does it get to where it needs to go? Do people use it? Do they even believe it? And what do patients get out of it?,” he asks.
The goals for creating patient portal content should be to ensure the information being provided is clear, presented using positive wording, and includes action items that help patients understand the next steps in their care, Dr. Klatt says. From a technological perspective, the content should be easy to view and download using various devices, including laptops and smartphones.
To measure the accessibility and ease of comprehension of information shared via patient portals, Dr. Klatt suggests conducting focus groups with a wide range of users, including patients of varying ages, socioeconomic backgrounds, and levels of familiarity with technology.
For patients who lack graphical literacy and have difficulty understanding the significance of numbers when multiple values are present at once, the raw data output of pathology tests can be difficult to decipher without prior training, Dr. Klatt notes. Therefore, pathologists should provide the gist, or essential meaning, of factual information in patient portals. For example, numeric data can be converted to natural language qualifiers, such as the words majority or minority, which can also reduce the perception that differences in data values are significant, Dr. Klatt reported in the Journal of Pathology Informatics article.
Dr. Klatt also advocates color-coding test results to aid comprehension. “Most people do well with visual information,” he explains. Familiar color schemes, such as the red, yellow, and green used in traffic lights, can help patients automatically recognize the meaning of test result values.
To further enhance patient understanding, pathologists should provide with test result reference ranges an explanation that such ranges vary among healthy people based on numerous factors and that results slightly outside of a range may not be serious, Dr. Klatt says. The portal too should include a statement advising patients to speak with their health care providers to resolve uncertainties. Converting patient data to alternate units of measure can also improve understanding, particularly for those who underwent previous testing at health care systems that displayed results using different measurement units or scales, he adds.
In the Journal of Pathology Informatics article, Dr. Klatt referenced a study of nearly 2,000 rheumatoid arthritis and systemic lupus erythematosus patients, which found that what patients most want from a laboratory report is not an in-depth explanation of the lab test but what the test result means, how it ties into their overall medical history, and the next steps they should take in their care (Kelman A, et al. Patient Prefer Adherence. 2016;10:2501–2517). When those three concerns are not adequately addressed, patients tend to seek information independently on the Internet, Dr. Klatt says. This can be problematic and even contribute to mistrust of medical data if patients find answers on their own that they deem to be more favorable than the ones they received from their medical providers.
“Novices doing an Internet search will tend to pick from the top of the search menu, and what goes to the top is not necessarily the best medical information,” he says.
To reduce the risk of patients accessing misinformation or disinformation, Dr. Klatt suggests including links to respected medical information sources along with test results in the patient portal. Quality health care information specifically written for consumer audiences, such as information from the British nonprofit organization Cochrane (www.cochrane.org), is particularly useful, he says.
When adding a test result that indicates further medical care is required to a patient portal, include action items that explain treatment options, Dr. Klatt advises. This can not only help patients better understand the recommended course for their care, but it helps frame abnormal findings more positively, he says.
“If you are indicating a cancer diagnosis, the messaging can say, ‘We have a result that indicates there is a treatment plan available.’ So the message is not that this is a bad result, it’s ‘this is a result that lends itself to a specific treatment plan,’” Dr. Klatt says.
“Obviously the goal would be for the provider who ordered the test to be the first one to deliver the [concerning] news, but sometimes scheduled visits don’t happen in a timely manner, and some information is better than no information,” he says. Therefore, providing treatment options with bad news delivered via the patient portal can give patients the opportunity to consider their care options and prepare questions before meeting with their providers.
The importance of including treatment suggestions with test information in patient portals highlights the need for close collaboration between pathologists and the ordering physicians who will be making future patient care recommendations, Dr. Klatt says.
As you format and deliver information, he continues, “you have to talk to your clinician colleagues to learn what they want from the test information and what would make life easier for them in terms of communicating with their patients.”
—Renee Caruthers
Proscia gets FDA clearance for digital pathology product
The FDA has granted 510(k) clearance for Proscia’s Concentriq AP-Dx digital pathology solution, allowing the product to be used for primary diagnosis in the United States. The solution is approved for clinical use with the Hamamatsu NanoZoomer S360MD slide scanner.
Concentriq AP-Dx is designed to be used in patient care settings of all sizes, from individual reference laboratories to the largest hospital systems.
“This regulatory milestone reflects our tireless commitment to our mission of perfecting cancer diagnosis,” said Proscia CEO David West, in a company press statement.
Proscia, 215-608-5411