Patient discourses on real-time access to test results via hospital portals: a discourse analysis of semistructured interviews with Dutch patients

Abstract

Objective Real-time access to test results on patient portals can have advantages and disadvantages for patients. It confronts patients with a complicated decision, namely whether to consult results before the medical consultation. To gain a deep understanding of patients’ decision-making processes, we unravelled three discourses about real-time access to test results, each of which articulates a different set of values, assumptions and arguments. Our research question was what patient discourses on real-time access to test results can be distinguished?Design We conducted discourse analysis on 28 semistructured interviews.Setting Interviews were conducted with patients who had (no) experience with real-time access to test results. Our participants were treated in different hospitals, and therefore, used different portals since Dutch hospitals can choose from suppliers for their patient portals.Participants Patients with experience (n=15) and without experience (n=13) of real-time access to test results on a patient portal.Results We identified three discourses: (1) real-time access as a source of stress, which highlighted how real-time access could cause stress due to the complexity of deciding whether to access test results, the incomprehensibility of medical language and the urge to repeatedly check if test results were available, (2) anxiety reduction through real-time access showed how real-time access can reduce stress by reducing waiting times and (3) real-time access for self-management showed how real-time access can give patients an opportunity for self-management because they can make informed decisions and are better prepared for the medical consultation.Conclusion Our study shows the plurality in opinions on real-time access, which helps in forming different strategies to inform and support patients in order to realise optimal use of real-time access.