Repeated Access to Patient Portal While Awaiting Test Results and Patient-Initiated Messaging

Steitz BD, Turer RW, Salmi L, Suresh U, MacDonald S, DesRoches CM, Wright A, Louissaint J, Rosenbloom, ST

doi:10.1001/jamanetworkopen.2025.4019

Background
The 21st Century Cures Act mandates the immediate release of test results to patients via electronic portals, which can increase worry and drive patient-initiated messages. Health systems are seeking ways to understand and support patients during the waiting period for results.

Objective
To measure how often patients refresh the portal while awaiting test results and examine the relationship between this behavior and subsequent patient-initiated messaging.

Methods
This retrospective cross-sectional study analyzed over 968,000 outpatient test results from 290,349 adult patients at Vanderbilt University Medical Center (2022–2023). Researchers used portal access logs to detect “refresh” behavior and categorized tests by sensitivity (e.g., low-sensitivity metabolic panels vs. high-sensitivity biopsies). Logistic regression models examined associations between refresh behavior, patient characteristics, and messaging within 24 hours of result review.

Results
Patients refreshed the portal for 25.9% of test results, more often for high-sensitivity tests (39.3%) than low-sensitivity tests (24.9%). However, refresh activity for low-sensitivity tests was more strongly associated with patient-initiated messaging. This suggests that refresh behavior may reflect patient attitudes and worry rather than the sensitivity of the test itself.

Read the full study here.