| dc.description.abstract | After the 21st Century Cures Act (Cures Act) created penalties for blocking the delivery of information to patients, medical centers now release test results to patients immediately. VUMC achieved compliance with Cures Act implementation on January 20th, 2021, and on April 15, 2021, VUMC adjusted an email notification policy that stopped automatically notifying patients of their result availability unless they opted in. Our objective was to assess if patients changed their behaviors after these policy changes. We used EHR and audit log data to measure the proportions of patients who scheduled a new appointment, had a telehealth encounter, messaged their clinician, cancelled an appointment, repeatedly logged into the portal, and returned to their test results. To evaluate the changes in proportions of patients performing various behaviors around their receipt of their data at these 2 policy changes, we conducted an interrupted time series (ITS) analysis using segmented linear regression. The proportion of all patients who scheduled a new appointment in the portal increased by 4.5% at policy 1 (p<0.001) and by 2.1% at policy 2 (p=0.037). The proportion of all patients who had a telemedicine encounter did not change at policy 1 (p=0.218) and decreased by 0.8% at policy 2 (p<0.001). The proportion of all patients who sent a message to a clinician increased by 4.5% at policy 1 (p<0.001) and did not change at policy 2 (p=0.176). The proportion of all patients who returned to their test results decreased by 6.8% at policy 1 (p=0.001) and did not change at policy 2 (p=0.392). The proportions of all patients who cancelled an appointment and returned to the portal did not change at policy 1 (p=0.289, p=0.170) or policy 2 (p=0.477, p=0.779). Our work points to measurable changes in patient behavior that could help to track and predict how changes in access to information for patients map to burden for clinicians and information seeking behavior in patients. | |
