Important Issues

When the 21st Century Care Act regulations were written, the medical community was concerned about the unintended consequences of unfettered access by patients to their electronic records. A new study published in the JAMA Open Network suggests these changes may be leading to burnout for healthcare providers.

The regulations for the Act require immediate electronic access for patients to their test results, medication lists, and clinical notes. This access may be even before their physician or medical institution reviews it, which may lead to confusion and misinterpretation. 

The study, seen here, suggests as much based on messaging to provider inboxes. The study examined health results on the patient portal at Vanderbilt University Medical Center between January 2020 and April 2021. CURES Act compliance began January 2021, so the study included pre- and post-CURES best practice. 

Prior to January 2021, patients viewed 10.4% of their test results before their clinician. After CURES implementation, that number jumped to 40.3% of patients viewing their results prior. The result was more EHR messages. Pre-January 2021, a median of 77.5 messages were sent within 6 hours of viewing the test results by patients. After CURES, the number jumped to 146 within 6 hours of viewing the results.

While the authors acknowledge the dataset is limited, they also point to the potential burdens on clinician wellbeing. The authors write:

Improved availability of data to patients represents a marked transformation in patients’ opportunity to take ownership of their health care. However, the benefit associated with immediate release of test results may be overshadowed by unintended consequences to patient well-being and clinical workload. Additional consideration of the timing of test result release to patients and clinicians is necessary to ensure that results are made available to patients while maintaining the opportunity for clinicians to apply their expertise and interpretation.