Perspectives of Patients About Immediate Access to Test Results Through an Online Patient Portal

What do 8000 patients think about the immediate release of test results since the 21st Century Cures Act Final Rule on information blocking? 96% preferred receiving immediately released results online even if their health care practitioner had not yet reviewed the result. (and more!)

Steitz et al article in JAMA Network Open: Perspectives of Patients about Immediate Access to Test Results

This collaboration between UT Southwestern, Vanderbilt, Beth Israel Deaconness and UCHealth surveyed over 43,000 patients, with 8139 respondents (18% response rate).

Thanks to Drs. Steitz, Turer, MacDonald, Rosenbloom, DesRoches for close collaboration, and to all team members, including the excellent Chief Patient Information Officer, Liz Salmi, for perspectives, insights and enthusiasm. This was a fun project to be part of.

It is the largest analysis of patient portal users’ attitudes about seeing test results immediately. Some key findings:

    • The survey findings suggest that patients and care partners who use the portal overwhelmingly prefer to have immediate access to test results, even if it means viewing them prior to discussing with their care team.
    • This holds true even among patients who reported that their tests were abnormal.
    • Despite the preference to continue immediately receiving test results, abnormal test results were associated with increased worry among respondents.
    • There was a non-significant protective association between whether a clinician discussed the reason for and implications of the test at the time of ordering and reduced patient worry.

CMIO’s take? Another push towards information transparency with patients. 96% of an 8000 patient survey indicate that they prefer having immediate access to test results, even if their physician/APP had not seen the result, and even if the result was abnormal. Some respondents did worry more with abnormal results, and there is an opportunity for us to improve our tools and workflow for those patients.

CT Lin’s CMIO interview with SeamlessMD

Thanks to Joshua Liu and Alan Sardana for a great chat spanning decades of my informatics career. We cover:

  • My ukulele origin story
  • My failure resume examples
  • How AI is nibbling at healthcare
  • P-values versus Change Management
  • How CT Lin ruined healthcare

How to Log Off (MIT tech review)

Wellness requires controlling your tech. Favorite quote: “What is your bigger, better offer?”

from MIT tech review

If you’re like me, you struggle with the addiction to online media sites (eg: what you scrolling right now, that you’re reading this?).

Love the ideas on this post from the MIT technology review, particularly step 3: find the “bigger, better offer”, once you recognize: you’re in a habit loop, the endless scroll triggers micro-dopamine. Create even a small break in that cycle and find something that is a “bigger, better offer” that is aligned with what YOU want out of life, not just mindless scrolling.

Good luck to all of us.

Perception Box: Elizabeth Koch’s take on self-examination and connection with others (NYTimes)

“The Billionaire’s Daughter Knows What You’re Thinking” (and she’s not wrong)

I’m hopeful when I read articles about people like Ms. Koch. Daughter of a billionaire, very much aware of her privilege, and exploring herself and inviting others to examine their own assumptions about their own lives and that of others.

CMIO’s take? I think we need more introspection and openness like this.

Infinite AI Interns for Everybody (

Here is our next AI challenge, as our jobs undergo gradual transformation. How will we as knowledge workers in informatics accommodate the growing sophistication of narrow AI assistants? Scheduling appointments, helping with spelling and grammar, now writing fluid manuscripts based on the library we point them to?

Teachers are starting to change “take home” assignments to in-class writing with no internet connection, to ensure students don’t outsource their thinking/writing to an AI chatbot.

What will we do? Can an AI replace us in writing the “one-pager” that summarizes thinking and succinctly and convincingly makes the case for change? Is Machiavelli vulnerable to being toppled? Do we no longer have need for governance and leadership if we can outsource thinking and fluency to an AI? Will my AI go up against your AI in the battle for mindshare?


CMIO’s take? Yet again, time to re-imagine our jobs with the tools we have at hand.

What are your non-negotiables / daily joyful habits? (NYtimes)

Do you have a daily habit that brings you joy, or clarity, or peace? Why? or why not? NYTimes asked its readers.

Link to article below:

What Are Your ‘Non-Negotiables’? Readers Share Wellness Rituals – The New York Times (

We know that setting fewer goals (actually setting just ONE dramatically improves your likelihood of success) is better for you. And in the pursuit of that one goal, setting a daily habit is crucial to achieving it.

If, for example, your goal is “being present” or “being more joyful”, it helps to set a daily habit that moves you in the right direction. Is it a daily walk? a daily 30 minute read? A daily 10 minute sketch? A daily swim? Stretch? Birdwatch?

From the article, I particularly love the “gin rummy” habit at 6pm, between husband and wife. Popcorn, hot tea, play 5 hands, fiercely contested, joyfully celebrated by the winner. And, 5 minutes later, no one can remember who won.

CMIO’s take: Dear readers, what non-negotiable daily habit do YOU have that brings you joy, and can share with us? We are all looking for inspiration.

How you name YOUR teams (the daily JIG)

Do you have fun at work? Do you have committees named WONK, Large PIG, Small PIG, PIGlets, Daily JIG, SONG, PROM, SPOC, EMO? Perhaps GUANO? Maybe we did.

Thanks to our intrepid, good-humored team of informaticists at UCHealth. Led by myself and Alice Pekarek, our Director of Clinical Informatics, our team of nearly 40 physicians/APPs/nurses (not all pictured here), are the reason that our electronic health record works as well as it does for us. We are taking a well-deserved break at a local watering hole.

Sure, we are nowhere near where we would like to be, but our teams are laser-focused on making improvements, reducing clinician burden, improving information transparency for our patients, taking us to the next level for high quality patient care.

And, they’re fun to work with. A sample of how we’ve named our teams:

Large PIG: Physician/APP Informatics Group. We meet monthly to discuss ongoing high profile projects and debate system-level changes that affect all 4000 physicians/APPs, all 12 hospitals and affiliates.

Small PIG: my Senior Medical Directors of Informatics, my “kitchen cabinet” of advisors

PIGlets: our newest physician/APP informaticists, who participate in our book club, with Leading Change, Crucial Conversations, Good to Great, and our current book for next month, Wabi Sabi: the wisdom in imperfection (Suzuki).

Daily JIG: At the height of the pandemic in 2020, our Joint Informatics Group (nurse informaticists as well as physician informaticists) met daily to hash out rapidly changing protocols and build tools to support best practices.

WONK: Workgroup Orderset Nowledge Kommittee (ok, I had to torture the words to make this work; our system-wide orderset synchronization efforts)

SONG: System Operations Note Group (unifying progress note templates)

PROM: Provider Review and Operations Management. Ambulatory proposed tweaks to our EHR, discussion and approval

SPOC: System Protocol Operations Committee

EMO: Electronic Medication Optimization

GUANO (Ok, this was a failed attempt to get the Allscripts Touchworks Academic Advisory Group to agree to Group of Users at Academic-centers, the National Organization). This was not approved. 🙁

CMIO’s take? Where are YOU injecting fun / humor / moments of joy into your work? Let me know!

My conversation on Designing for Health (podcast and a ukulele song)

What does mindfulness mean to a CMIO? Also, patient engagement, information transparency, and FAILURE? And finally, gratitude. Listen all the way through for a special treat. #Podcast #healthcare #healthIT #hitsm #whyinformatics #hcldr #somedocs

You’ve been choosing your goals all wrong (Wired)

Yup, what were you thinking? Don’t you know each goal cascades into multiple sub-goals, and pretty soon, you’re drowning? So what is the solution?

Photo of author’s son, from our visual travelogue as we hiked The Narrows in Zion Canyon a couple years ago.

CMIO’s take? Set a goal (not multiple goals: ONE), and have the discipline to choose a daily habit to support it. Set it SMALL. No, smaller than that. And then stick to it. Yes, let’s both try it.

Acoustic tweezers for kidney stones? Acoustic holograms for imaging? (nytimes)

Borrowing from electron microscopy and laser physics, we can now use sound waves to move things and see things differently? See the New York Times article link above.

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