Many oncology providers are against the immediate release of clinical information (IRCI) to patients, according to a survey published in JCO Oncology Practice.1
Most oncology providers surveyed said the IRCI mandate put in place by the 21st Century Cures Act has had a negative impact on their practice and their patients.
The 22-question survey was sent to all Association of American Cancer Institutes members. It was sent twice in 2021, with a 3-month period between each send. An additional survey with a single question about providers’ adaptation to the IRCI mandate was sent 1 year later to providers who responded to the first survey at either time point.
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A total of 167 providers responded to the first survey at either time point, and 31 responded to the 1-question survey. Most respondents (95.2%) said they had some knowledge of the new IRCI changes, but 8 respondents did not. These 8 individuals were omitted from the final cohort, so the final cohort consisted of 159 respondents.
The respondents’ areas of expertise included hematology/medical oncology (n=98), surgical oncology (n=26), gynecologic oncology (n=7), radiation oncology (n=6), neuro-oncology (n=3), pathology (n=2), radiology (n=1), and other areas (n=16).
Impact and Perception of the IRCI Mandate
Most respondents said the IRCI mandate had a negative impact on their patients. A negative impact was reported by 72.4% of the hematology/medical oncology providers and 82% of the other providers.
Overall, about three-quarters of respondents said the IRCI mandate had a negative impact on their practice or their patients — 75% at the first time point and 73% at the second time point.
The researchers noted that the 1-question survey showed “a more positive response to the adaptation of the IRCI policy” 1 year later, but they pointed out that this survey only had 31 respondents.
The proportion of respondents who were not in favor of the IRCI mandate was 82% at the second survey time point, and this decreased to 58% at the time of the 1-question survey. Respondents who were in favor of the IRCI mandate increased from 18% to 42%.
In the overall cohort, more than 60% of respondents said they were informing patients that they might see results before being able to discuss them with providers. More than 80% of respondents said their patients’ preference would be to discuss results before they are released.
However, prior studies and anecdotal reports have suggested that patients want immediate access to their information or would like to have the choice of opting in or out of immediate access.2
“Recognizing the patient’s right to have timely access to personal health information and allowing for interoperability should be balanced with specific interventions to mitigate potentially harmful consequences of IRCI in the oncology field,” the authors of the current study wrote.1 “Cancer centers should continue exploring optimal approaches for sharing relevant health care information with providers and patients.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
References
1. Anyidoho PA, Verschraegen CF, Markham MJ, et al. Impact of the immediate release of clinical information rules on health care delivery to patients with cancer. JCO Oncol Prac. Published online February 13, 2023. doi:10.1200/OP.22.00712
2. Rodriguez T. Patient portals in oncology: Helpful or harmful? Cancer Therapy Advisor. Published February 10, 2023.
This article originally appeared on Cancer Therapy Advisor
