Technological progress vastly influences many aspects of our lives, and health care is among the forefront of many of these developments. With new tests, genetic screening, electronic filing, telehealth, remote monitoring tools, and many more advancements over the past decades, the health landscape is evolving rapidly. Currently, there is discussion in Canada over the benefits and harms of allowing patients online access to their health data, especially lab results.
Some medical professionals express concern that this information could cause anxiety in patients who don’t know how to interpret lab results, and that it is best for the patient to review this information with their doctor during an appointment. Many others proclaim it is beneficial to have the increased patient engagement and awareness that comes from patients taking aspects of health care into their own hands. Either way, these online services have been available in parts of Canada for several years, and are growing in popularity.
Instant Access to Lab Results
When you have lab work done, such as blood, urine, or stool tests, your physician receives a document containing information about blood cell counts, minerals, certain bacteria or viruses present, medicine levels, and many other components, depending on which tests they choose. Now, there are some lab services that allow patients immediate access to these documents online, without needing to contact their physician or clinic.
A service called my ehealth, which allows patients access to lab results through an online portal, has been available in British Columbia since 2010, and Ontario since 2015. Patients sign up through the website at www.myehealth.ca using their personal health number. Then, after visiting LifeLabs, the prevalent lab service in these provinces, they can login and view the results as soon as they become available, often within twenty-four hours. The website keeps track of all results from tests taken after signing up with the website, so it is possible for the patient to compare results over time in online reports.
Recently, Nova Scotia launched a similar service called MyHealthNS, which is available at www.myhealthns.ca. Other provinces have plans to introduce online access to lab results in the future.
Health Data in BC
In 2015, the Social Research and Demonstration Corporation (SRDC), a Canadian non-profit research organization, conducted a study on the effects of direct access lab results for patients in Canada.1 They conducted telephone surveys with twenty doctors in British Columbia and an online survey for British Columbia residents who had a lab result in the past twelve months, and compared data from 2,047 individuals who access their lab results online and 1,245 individuals who have to contact their physician or clinic to access lab results.
The Patient Experience
Wait times are an ongoing problem for many Canadians when it comes to health care access.2 Getting in to see a physician, whether it is your general physician or a specialist, can take quite some time. In this survey, only 36% of the survey respondents who had to make an appointment got results within a few days, compared to 82% of those who could access results online. In addition, 11% of those without online access had to wait longer than two weeks to see results, but only 2% of those with online access had to wait that long.
Many of the individuals who use online access programs have chronic health conditions (60%) and required more than three lab tests in the past year (63%). Interestingly, the researchers found that despite expecting young people to use this service more frequently, it was older people who use it the most, likely because individuals in this demographic are more likely to have chronic illnesses.
Those who use online health data reported higher levels of satisfaction with both the overall process of receiving their results and the timeliness of their results, than those who had to consult with a physician.
The study also found that while all users were most likely to use an internet search if they wanted to find out more information about their test results, only 22% of those who spoke with their physician did an internet search to learn more about their results, compared with 42% of those who got their results online. Therefore, it is important for patients to know how to find the right medical information online, to avoid further confusion or anxiety.
Patients who viewed results online were also less likely to know if they needed to follow up with their physician, and were less confident that they understood their lab results. However, there were no significant differences in the levels of anxiety reported after receiving test results between these two groups.
The Physician Experience
While the physicians involved in the survey are apprehensive about certain challenges, they find that the increased patient engagement, empowerment, and autonomy makes this technology beneficial overall. It can be motivating for patients to see the direct effects of not taking medicines or not following the correct diet, which can lead to them making more changes to improve health.
The physicians’ largest concern is how patients cope with their results. For some individuals, seeing an out-of-range number in their lab results could lead to worry and anxiety, even though in many cases a physician would be able to explain that the result is not necessarily bad, that there might not be a problem, or that it could be something easy to fix. However, as the results of the patient survey show, these concerns might not be warranted. And, on the other hand, patients might experience less anxiety when they can see nothing wrong in their test results right away, instead of having to wait days or weeks for an appointment, wondering what the tests will say.
Some physicians also thought that giving patients access to their results might increase their work load, not decrease it, because more patients would call to ask questions or clarify information. But once again, the patient survey shows that this might not be the case.
The consensus of the physicians is that this technology is especially useful for individuals with chronic conditions who already understand what their lab results mean and what to do when a number is out-of-range. For example, a patient with a history of anemia might understand that if their blood results show low iron levels, then they need to continue taking supplements, and might not necessarily require an appointment with a physician to clarify this information.
While there are some concerns over potential anxiety for patients, this new technology offers many benefits. Accessing results online increases flexibility, timeliness, and satisfaction for patients, does not increase anxiety, and could lead to a reduced workload for physicians. Individuals with chronic illness have the most to gain by using online access because they typically require frequent lab tests and understand how to interpret these routine lab results.