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Appl Clin Inform 2025; 16(02): 345-349
DOI: 10.1055/a-2494-1722
Research Article

Timing of Liver Imaging Result Release Is Associated with Patients with Cirrhosis Reviewing Results Prior to Providers

Jeremy Louissaint
1   Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, United States
,
John Deng
2   Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, United States
,
Elliot B. Tapper
3   Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States
,
Robert W. Turer
4   Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, Texas, United States
5   Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States
,
Timothy P. Hogan
6   O'Donnell School of Public Health, UT Southwestern Medical Center, Dallas, Texas, United States
7   Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, United States
,
Sruthi Yekkaluri
1   Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, United States
,
Patrick Dunn
8   American Heart Association, Center for Health Technology and Innovation, Dallas, Texas, United States
,
Amit G. Singal
1   Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, United States
› Author Affiliations
Funding J.L. is funded by the American Cancer Society Institutional Research Grant (IRG-21-142-16) and the University of Texas Southwestern Dean's Scholar in Clinical Research program. R.W.T. is supported by the Texas Health Resources Clinical Scholar Award. A.G.S.'s research is supported by NIH R01 CA212008, R01 CA222900, and U01 CA283935 and CPRIT RP200554. This work was supported by resources from the University of Texas Southwestern Clinical and Translational Science Award Program (UL1TR001105).
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Abstract

Background Patients with cirrhosis are at high risk for developing hepatocellular carcinoma (HCC), warranting receipt of semiannual surveillance imaging with the potential to identify abnormal liver lesions. Since the implementation of the 21st Century Cures Act's Information Blocking provision, test results are immediately released to patients through the patient portal. There is an increasing trend of patients reviewing their results before their providers.

Objective We aimed to determine whether the date and time characteristics of when the result is released to the electronic health record (EHR) are associated with patients reviewing results before providers.

Methods In patients with cirrhosis undergoing ambulatory liver imaging, the date–time characteristics of when the result was released to providers in the EHR were categorized as outside regular work hours for holidays, weekends, or outside normal business hours. Logistic regression was used to determine the relationship between results released to the EHR outside work hours and whether the patient or provider was the first to review the result.

Results We identified 850 imaging studies from 401 patients with a median age of 62 (interquartile range [IQR]: 53–69) years. Patient time to result review was shorter or equivalent to their providers for 57% of the results. A total of 170 (20.0%) of results were released outside regular work hours. There was an increased odds of the patient reviewing the result before providers for results released outside regular work hours (adjusted odds ratio [aOR] = 1.54, 95% CI: 1.08–2.20).

Conclusion HCC screening results released to the EHR outside regular work hours is associated with patients reviewing these results before providers.

Keywords

patient–provider communication - 21st Century Cures Act - patient portal - hepatocellular carcinoma

Protection of Human Subjects

The study was approved by the Institutional Review Board at the University of Texas Southwestern.


Note

J.L. is the guarantor of this article.


Authors' Contributions

Concept: J.L., A.G.S., and E.B.T.


Data Acquisition: J.L., J.D.


Analysis: S.Y., J.L.


Writing: J.L.


Critical revision: J.D., P.D., T.P.H., A.G.S., E.B.T., and R.W.T.


Supplementary Material



Publication History

Received: 10 July 2024

Accepted: 30 November 2024

Article published online:
16 April 2025

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