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1911. Patient Electronic Access to Final Radiology Reports: What is the Current Standard of Practice and is an Embargo Period Appropriate?
Authors * Denotes Presenting Author
  1. Grace Jin; Yale University
  2. Jonathan Mezrich *; Yale School of Medicine
  3. Carolyn Lye; Yale School of Medicine
  4. Laurie Yousman; Yale University
  5. Howard Forman; Yale School of Medicine; Yale University
Objective:
Patients have a right to their medical records, and it is becoming commonplace for institutions to set up online portals through which patients can access their health information, including radiology reports. Early patient access to health information is important as it allows patients to better participate in their health care, become their own advocates, can lead to correction of errors and may be protective for radiologists in terms of decreasing risk for failure to communicate findings. Federal HIPAA and HITECH legislation require prompt timely electronic access but not immediate access. Because of flexibility under the law, many institutions reportedly use “embargo” periods during which radiology reports are not immediately released to patients, either due to technological hurdles, or in many cases to give ordering clinicians an opportunity to first review and discuss the report with patients. However it is unclear whether there is a consensus approach to use of embargo periods.

Materials and Methods:
IRB exemption was obtained. A telephone survey was conducted of 83 top hospitals identified from the 2019-2020 U.S. News & World Report Hospital Rankings via a “secret shopper” approach whereby a mock patient/family member would inquire as to a hospital’s portal access services and policies.

Results:
70 responses were obtained, representing an 84% response rate; not every respondent answered every question. Of those respondents, 64 (91%) offer online portal access, while 6 (9%) do not. 22 (31%) hospitals reported an embargo period of 1-3 days, 8 (11%) reported an embargo period of 4-6 days, 6 (9%) reported an embargo period of 7-14 days, while 13 (19%) reported an indefinite period. 33 (47%) hospitals indicated they would first send the report to patient’s treating clinician for review, while 14 (20%) would not.

Conclusion:
While the majority (91%) of responding institutions offer online portal access to patients, there appears to be no consensus standard with respect to embargo periods. Given the benefits both to patients and possibly institutions in providing early access, further guidance and discussion amongst chief medical/information officers is warranted.