Psychological Safety Outcomes of EHR Released Oncology Test Results in Vulnerable Patients: A Rapid Review

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Publication Date

4-8-2026

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Presentation: 21:51

Abstract

The 21st Century Cures Act of 2016, implemented in 2021, prohibits healthcare providers and organizations from restricting patient access to medical records, including pathology, radiology, and laboratory results (21st Century Cures Act, 2016; 2021). Consequently, health information is routinely released through electronic health records (EHRs) and accessed via patient portals. Although approximately 95% of patients prefer immediate access to test results, 87% of those receiving critical diagnoses report a preference for results to be accompanied by provider guidance or healthcare support (Salmi et al., 2024).

While transparency and access are central to patient‑centered care, rapid digital disclosure particularly in oncology raises concerns related to psychological safety. Although the policy promotes patient autonomy, oncology‑related disclosures may result in unintended psychological consequences, especially among vulnerable populations such as individuals with low health literacy, cognitive impairment, or limited social support.

To examine these implications, a rapid review was conducted utilizing the databases PubMed/MEDLINE, CINAHL, PsycINFO, and SCOPUS. Of 109 records screened by keywords, MeSH terms, titles, and abstracts, 18 studies met inclusion criteria. Eligible studies included adult oncology patients aged 18 years and older; EHR or patient‑portal–based disclosure of cancer‑related test results without immediate clinician guidance; and assessment of psychological outcomes, including anxiety, distress, perceived vulnerability, diminished trust, and mitigation strategies.

Findings indicate that patient‑portal disclosures of oncology results frequently increase anxiety, confusion, and perceived loss of safety. This distress can be intensified when results appear outside of normal clinic hours, (Salmi et al., 2024) Although supportive interventions can mitigate psychological harm, these strategies remain underutilized.

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English

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