Article

Nurse and Physician Perspectives on Patients With Cancer Having Online Access to Their Laboratory Results

Elizabeth S. Rodriguez

Bridgette Thom

Susan M. Schneider

interdisciplinary communication, patient empowerment
ONF 2011, 38(4), 476-482. DOI: 10.1188/11.ONF.476-482

Purpose/Objectives: To compare the perspectives of oncology nurses and physicians regarding online access to laboratory results for patients with cancer pre- and postimplementation, and to evaluate the impact on workload.

Design: Pre- and postimplementation surveys distributed to nurses and physicians. In addition, a nursing workload study was conducted to measure the number of phone calls received from patients regarding laboratory results.

Setting: The outpatient department of a comprehensive cancer center in a large, urban setting in the northeastern United States with more than 500,000 patient visits each year.

Sample: 460 outpatient nurses and 349 attending physicians were surveyed; 10 of those nurses were invited to participate in the nursing workload study, as well.

Methods: A survey was sent to nurses and physicians one month prior to implementation and then repeated six months postimplementation. A nursing workload study was conducted for 16 weeks beginning one month prior to implementation and completed three months postimplementation.

Main Research Variables: Nurse and physician perspectives; nursing workload

Findings: Nurses demonstrated greater support than physicians with regard to patient access, their level of comfort with the patient access, and patients' ability to interpret results. Statistical significance was identified in all three questions (p < 0.05). Perspectives on workload did not differ by role; nurses and physicians anticipated an increase in workload prior to implementation, but reported that workload decreased or stayed the same postimplementation (p < 0.005). The nursing workload study supported that finding because no change was observed in the average number of phone calls per day during the implementation period.

Conclusions: Oncology nurses and physicians have different perspectives on providing patients with cancer with online access to laboratory results. Concerns about increasing workload were not substantiated in the current study.

Implications for Nursing: Providing patients with online access to their laboratory results is a growing trend. Understanding the perspectives of oncology nurses can inform future directions for increasing health-record transparency for patients with cancer. Future research may explore the impact on the nurse-patient relationship.

Jump to a section

    References

    Businger, A., Buckel, L., Gandhi, T., Grant, R., Poon, E., Schnipper, J., … Middleton, B. (2007). Patient review of selected electronic health record data improves visit experience. AMIA Annual Symposium Proceedings, 887.
    Hassol, A., Walker, J.M., Kidder, D., Rokita, K., Young, D., Pierdon, S., … Ortiz, E. (2004). Patient experiences and attitudes about access to a patient electronic health care record and linked Web messaging. Journal of the American Medical Informatics Association, 11, 505-513. doi:10.1197/jamia.M1593
    Masys, D., Baker, D., Butros, A., & Cowles, K.E. (2002). Giving patients access to their medical records via the Internet: The PCASSO experience. Journal of the American Medical Informatics Association, 9, 181-191. doi:10.1197/jamia.M1005
    Ralston, J.D., Hereford, J., & Carrell, D. (2006). Use and satisfaction of a patient Web portal with a shared medical record between patients and providers. AMIA Annual Symposium Proceedings, 1070.
    Ross, S.E., & Lin, C.T. (2003). The effects of promoting patient access to medical records: A review. Journal of the American Medical Informatics Association, 10, 129-138. doi:10.1197/jamia.M1147
    Ross, S.E., Todd, J., Moore, L.A., Beaty, B.L., Wittevrongel, L., & Lin, C.T. (2005). Expectations of patients and physicians regarding patient-accessible medical records. Journal of Medical Internet Research, 7, E13-E22. doi:10.2196/jmir.7.2.e13
    Siteman, E., Businger, A., Gandhi, T., Grant, R., Poon, E., Schnipper, J., … Middleton, B. (2006). Clinicians recognize value of patient review of their electronic health record data. AMIA Annual Symposium Proceedings, 1101.
    Sorensen, L., Shaw, R., & Casey, E. (2009). Patient portals: Survey of nursing informaticists. Studies in Health Technology and Informatics, 146, 160-165.
    Wald, J.S., Burk, K., Gardner, K., Feygin, R., Nelson, E., Epstein, M., … Middleton, B. (2007). Sharing electronic laboratory results in a patient portal—A feasibility pilot. Studies in Health Technology and Informatics, 129(Pt. 1), 18-22.
    Weingart, S.N., Rind, D., Tofias, Z., & Sands, D.Z. (2006). Who uses the patient internet portal? The PatientSite experience. Journal of the American Medical Informatics Association, 13, 91-95. doi:10.1197/jamia.M1833
    Wiljer, D., Bogomilsky, S., Catton, P., Murray, C., Stewart, J., & Minden, M. (2006). Getting results for hematology patients through access to the electronic health record. Canadian Oncology Nursing Journal, 16, 154-164.