Table 1.
Study characteristics.
| Author and country | Study objective | Research design; method of data collection | Participants and sample size | Participant demographics and health condition | Health care, setting, and portal technology |
| Baun et al [50], Denmark | Explore experiences of women with cancer using EHRa to view imaging results | Mixed methods; survey and interviews | Patients (women undergoing scans every 3 mo); 38 surveyed and 4 interviewed | Survey respondents: White, aged 42-84 (median 69) y; interview informants: aged >40 y; 23 portal users | Department of Nuclear Medicine, Odense University Hospital; Denmark’s national portal |
| Edmonds et al [26], United States | Identify patient characteristics associated with use of portals to view their bone density results | Quantitative nonexperimental; survey | 649 patients viewing bone density scan via portal | Aged >50 (mean 64) y; other data reported for a larger sample, including portal nonusers | Two sites: UIb and KPGAc; EPIC portals: MyChart (UI) MyHealthManager (KPGA) |
| Foster and Krasowski [27], United States | Examine portal activation and access to diagnostic tests by EDd patients | Quantitative nonexperimental; retrospective analysis of EPIC Reporting Workbench for 12 mo in 2016-2017 | Patients with at least 1 ED encounter and 1 test; data sets: 208,635 laboratory tests on 25,361 unique patients; 23,504 radiology studies on 14,455 unique patients. Approximately 37% of patients had a portal account | All ages | Emergency department; UI hospitals and clinics (same as [19,31]); EPIC portal |
| Giardina et al [28], United States | Explore patients’ experiences with accessing test results via portals | Mixed methods; descriptive statistics and interviews | 95 patients | Average age 54.6 y; 56% male; 65% White; 62% with one or more chronic conditions; 72% use portal for at least 1 y | 4 large outpatient clinics in Houston, including primary care clinics and VAe facilities; MyChart (EPIC) and MyHealtheVet |
| Henshaw et al [29], United States | Examine patients’ and referring HCPs’f experiences of manually releasing radiology reports (no images) | Mixed methods; descriptive statistics, patient survey, HCP survey, and group interview | 508 patients; 48 referring HCP (physicians, physician assistants, and nurse practitioners) | Not reported | Kaiser Permanente Hawaii, primary care and specialty clinics; Kaiser Permanente portal |
| Hiremath et al [30], United States | Examine patient perceptions of a pilot access to images and radiology reports | Quantitative nonexperimental; survey | 456 patients | Aged 18-86 (mean 52) y; 64% female; over 80% used computer at least daily | Outpatient-imaging center; Image Share Project by the Radiological Society of North America |
| Hulter et al [44], Netherlands | Explore patient preferences for timing of result release | Mixed methods; portal use data and interviews | 4592 patients who indicated in the portal their preference for timing of tests; 7 patients interviewed | 36% male, mean age 56 (SD 15) y; 64% female, mean age 50 (SD 16) y | Dutch teaching hospital; portal brand not reported |
| Krasowski et al [31], United States | Evaluate variations in results release (automated vs manual) and subsequent patient access to the portal | Quantitative nonexperimental; retrospective analysis of EPIC Reporting Workbench for 6 mo in 2016 | Approximately 1.6 million results (anatomic pathology, lab, and radiology) for nearly 60,000 unique patients; anecdotal accounts | All ages | Outpatient, inpatient, emergency departments; UI hospitals and clinics; EPIC portal (same as [19,27]) |
| Mák et al [32], Canada | Explore patient comprehension and anxiety when viewing laboratory test results | Quantitative nonexperimental retrospective cohort study, survey, and comparison of portal users with nonusers | 2047 patients with portal access and at least 1 test in last 12 mo | Age: 62% above 55 y; 62% female; 77% rated health as excellent or good; 60% had chronic condition; 62% had at least 3 tests in last 12 mo | Preexisting laboratory database; dedicated portal to access laboratory results in British Columbia, Canada |
| Mangano et al [33], United States | Survey patients about their preferred method of receiving radiologic results and whether radiologists should communicate results directly to patients | Quantitative nonexperimental; survey | 642 patients undergoing contrast-enhanced CTg or MRIh | Age 18-80+ (mode 51-60) y; 87% had internet access; 44% aware of web access to radiology reports; 47% of those viewed imaging results | Large academic tertiary care medical center that operates 2 outpatient-imaging facilities; portal (unspecified) allows access to all kinds of test results and doctors’ notes |
| McFarland et al [45], United States | Examine portal enrollment, use and rates of patients viewing radiology and laboratory results | Quantitative; nonexperimental; analysis of EHR data | 424,422 patient records; 138,783 portal users | Mean age 49 (SD 21) y; 58% female; 58% White, 30% Black; 33% enrolled in patient portal | Single academic tertiary care center; Oracle Cerner portal |
| Miles et al [34], United States | Evaluate frequency of viewing radiology reports and demographic factors associated with report viewing | Quantitative nonexperimental analysis of system logs | 61,131 patients with at least 1 radiology report | 18-80+ y | University of Washington, medical center; University of Washington eCare portal |
| Norris et al [51], United States | Examine experiences and actions of patients accessing radiology results | Mixed methods; survey (closed and open-ended questions) | 299 patients | 58.5% aged 55+ y; 69% female | UCHealthi; MHCj portal |
| Okawa et al [35], United States | Compare physician patterns of releasing reports manually vs autorelease and examine patient viewing patterns | Quantitative nonexperimental; analysis of system data–number of reports released into portal and viewed by patients | Total number of reports available to patients in the portal 86,659 in 2015 | Reports released for 52,293 unique patients in 2015, of whom 56% were active on the portal | Outpatient-imaging center, outpatient departments, and EDs; Kaiser Permanente, Hawaii; Kaiser Permanente portal |
| Pillemer et al [36], United States | Examine impact of allowing patients to view their test results via patient portal | Mixed methods; interview with patients and physicians, survey of patients who are portal users, analysis of EHR data (service use pre- and postdirect result release; test viewers vs nonviewers), and portal use data | 6368 patients completed survey; 13 patients with HbA1ck or abnormal Papanicolaou result interviewed; sample size for HCP not specified; portal use and EHR data: 77,901 results released to 14,441 patients of whom test viewers, n=8486 | Patients test-viewers: mean age 51 y; 54% male; 91% White | UPMCl outpatient practices; EPIC MyChart branded as MyUPMC |
| Robinson et al [37], Canada | Understand why patients access laboratory results and impact on their health | Qualitative; interviews | 21 patients | Age: 18-80+ y; 62% between 60 and 79 y; 57% male; healthy to chronic illness | Primary Care Centre; EpicCare and myCARE portals |
| Rodriguez et al [41], United States | Compare views of oncology nurses and physicians on patient access to laboratory results pre- and postimplementation and impact on workload | Quantitative nonexperimental; survey and nursing workload (number of phone calls received from patients regarding laboratory results) | HCP: 187-251 nurses surveyed, 10 of them participated in workload study; 66-100 attending physicians surveyed | Nurses: mostly female, aged 25-54 y; physicians: 60% male, aged 35-54 y; majority confident in computer skills | Outpatient department of Memorial Sloan-Kettering Cancer Center, New York; Portal MyMSKCC, vendor not reported. |
| Schultz and Alderfer [38], United States | Explore caregivers’ preferred method of receiving test results and the disadvantages of portals | Mixed methods; interviews and survey | 19 family caregivers of children with cancer | Parents aged 25-49 (mean 40) y; 79% female; 26% Black or African American; pediatric oncology | Oncology clinic; EPIC MyChart (MyNemours) |
| Talboom-Kamp et al [46], Netherlands | Investigate experiences and self-efficacy of patients using portal to view laboratory results | Quantitative nonexperimental; survey (eHealth impact questionnaire) | 354 patients who are portal users | Not reported | Saltro, a primary care diagnostic center and laboratory; Saltro patient portal for laboratory results |
| Tossaint-Schoenmakers et al [47], Netherlands | Examine effect of patient characteristics on usability and self-efficacy when accessing laboratory results | Quantitative nonexperimental; survey | 748 patients | Mean age 58.5 y; 57% female; 57% highly educated (bachelor’s or higher); 68% reported no chronic illness | Diagnostic center; dedicated laboratory portal |
| Wakefield et al [48], United States | Examine the association between portal use and care coordination between multiple HCP through comparing duplication of HbA1c | Quantitative nonexperimental; portal use data, Medicare records, and comparison between portal users and nonusers | 30,186 veterans who use both VA and non-VA health services | Age: 25-85+ y; 98% male; 90% White; all patients with diabetes | VA and Medicare health facilities; MyHealtheVet Portal |
| Wald et al [39], United States | Feasibility pilot of patient access to their laboratory results to understand technical, workflow, and organizational challenges | Quantitative nonexperimental; survey and spontaneous comments | 128 patients surveyed 12 wk after pilot began; 10 physicians provided spontaneous and solicited feedback 8 wk after pilot began | Patients: mean age 42 y; 49% female | Two primary care practices; Eastern Massachusetts; Patient Gateway |
| Williams et al [42], United States | Analyze influence of organizational and technology characteristics on patient quality outcomes | Quantitative nonexperimental | System data from 1039 American hospitals; 2 databases (health information and management systems society analytics survey+center for Medicare and Medicaid service) | N/Am | Hospitals |
| Winget et al [43], United States | Examine perspectives of oncologists about autorelease of pathology and radiology reports after 7-d embargo | Mixed methods; survey: descriptive statistics and thematic analysis of comments | 82 oncologists completed survey, 35 of whom provided comments | Not reported | Stanford Cancer Center; portal brand not reported |
| Wood et al [19], United States | Examine changes in patient reviewing patterns before and after switch to immediate release of nearly all laboratory and imaging results | Quantitative nonexperimental; retrospective pre (10 mo)-post (10 mo) study and analysis of data from EPIC Reporting Workbench in 2020-2021 | 3,809,397 diagnostic tests from 204,605 unique patients; 56.5% female; 84% White; 96.5% preferred English as their primary language; 71% with active portal account | All ages | ED, inpatient, outpatient; departments; UI hospitals and clinics; EPIC MyChart (same as [27,31]) |
| Woolen et al [40], United States | Determine timing of imaging result release based on patients’ experience of portal use | Quantitative nonexperimental; survey | 418 patients with cancer, 43% of whom had at least some experience of portal use | Aged 11-65+ y; majority 50-64 y; 60% female; 66% White; 26% with cancer, depression, and cardiovascular disease | 4 outpatient sites from 2 institutions in 2 Midwestern states; portal brand not reported |
| Zhang et al [49], United States | Examine patients experience with comprehending laboratory results | Mixed methods; interviews and survey | 203 patients surveyed; 13 patients interviewed | Survey: aged 18-80+ y; most aged 26-49 y; 51% male, 69% White; interview: aged 18-64 y; 46% aged 26-49 y; 76% White; 70% female; 85% technology proficient | Health setting not reported; portal brand not reported |
aEHR: electronic health record.
bUI: University of Iowa.
cKPGA: Kaiser Permanente of Georgia.
dED: emergency department.
eVA: Veteran Affairs.
fHCP: health care provider.
gCT: computed tomography.
hMRI: magnetic resonance imaging.
iUCHealth: University of Colorado Health.
jMCH: My Health Connection.
kHBA1c: glycated hemoglobin.
lUPMC: University of Pittsburgh Medical Center.
mN/A: not applicable.