ArticleJournal of the American Medical Informatics Association : JAMIA2024
Do patients who read visit notes on the patient portal have a higher rate of "loop closure" on diagnostic tests and referrals in primary care? A retrospective cohort study.
Article in Journal of the American Medical Informatics Association : JAMIA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Understanding and Addressing Delays in Endocrine Surgery: Insights From a Mixed-Methods Study and a Pilot Educational Intervention.Journal of surgical oncology · 2026Article
- Article
- How and Under What Conditions Do Patient Portals Improve Cancer Screening Completion: A Scoping Review.AJPM focus · 2026Review
- A Dataset for Addressing Patient's Information Needs related to Clinical Course of Hospitalization.Scientific data · 2026Article
- The role of health, sociodemographic, and care delivery factors in timely completion of colonoscopy in a US-based primary care population: a retrospective analysis.BMC gastroenterology · 2026Article
- Patient Perspectives on Delayed Specialty Follow-Up After a Primary Care Visit.Journal of the American Board of Family Medicine : JABFM · 2025Article
- Interventions to improve timely cancer diagnosis: an integrative review.Diagnosis (Berlin, Germany) · 2025Review
- Patient and Family Perceptions of Real-Time Access to Electronic Health Information: A Social Media Survey.Applied clinical informatics · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
objectivesThe 2021 US Cures Act may engage patients to help reduce diagnostic errors/delays. We examined the relationship between patient portal registration with/without note reading and test/referral completion in primary care. MATERIALS AND
methodsRetrospective cohort study of patients with visits from January 1, 2018 to December 31, 2021, and order for (1) colonoscopy, (2) dermatology referral for concerning lesions, or (3) cardiac stress test at 2 academic primary care clinics. We examined differences in timely completion ("loop closure") of tests/referrals for (1) patients who used the portal and read ≥1 note (Portal + Notes); (2) those with a portal account but who did not read notes (Portal Account Only); and (3) those who did not register for the portal (No Portal). We estimated the predictive probability of loop closure in each group after adjusting for socio-demographic and clinical factors using multivariable logistic regression.
resultsAmong 12 849 tests/referrals, loop closure was more common among Portal+Note-readers compared to their counterparts for all tests/referrals (54.2% No Portal, 57.4% Portal Account Only, 61.6% Portal+Notes, P < .001). In adjusted analysis, compared to the No Portal group, the odds of loop closure were significantly higher for Portal Account Only (OR 1.2; 95% CI, 1.1-1.4), and Portal+Notes (OR 1.4; 95% CI, 1.3-1.6) groups. Beyond portal registration, note reading was independently associated with loop closure (P = .002). DISCUSSION AND
conclusionCompared to no portal registration, the odds of loop closure were 20% higher in tests/referrals for patients with a portal account, and 40% higher in tests/referrals for note readers, after controlling for sociodemographic and clinical factors. However, important safety gaps from unclosed loops remain, requiring additional engagement strategies.
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