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Patients fail to understand significant terms in EHR information: study

by John R. Fischer, Senior Reporter | August 25, 2022
Health IT
Patients do not comprehend the definitions of medical terminology used in EHRs.
Due to a poor understanding of medical terminology, patients may struggle to comprehend their health information when reading pathology and radiology reports.

Under the 21st Century Cures Act that took effect in April 2021, healthcare providers must release electronic health information to patients immediately. But many are concerned that reports with this information are written with clinicians in mind, and that patients may not understand them.

Researchers at the University of Colorado School of Medicine verified this in a breast pathology survey of 527 participants, finding that they did not understand certain terms or if they meant good or bad news.

The words were malignant, benign, metastatic, neoplasm, negative, mass, carcinoma, and high grade. About 80% and 73% correctly defined malignant and benign, respectively, but were less successful with the others.

“Our aims were to get a clearer picture of what patients were understanding and not understanding, and to learn more about what educational tools patients would find most helpful. We’re seeing this need not just in breast oncology and surgery, but across all areas of healthcare,” said lead author Alexandra Verosky, a third-year medical student at the University of Colorado School of Medicine, in a statement.

More than 40% could not define neoplasm. While over 95% correctly identified malignant as bad news, high grade was the most commonly misidentified word. For carcinoma, 82% were partially accurate in their definition, but over 10% wrote that it could be good or bad news.

Whether or not the respondent was a healthcare worker also did not change comprehension. Most suggested incorporating a brief summary paragraph and an integrated electronic tool to define words.

Since the majority were white and college educated, Verosky says a Spanish version of the survey will be distributed to assess different patient populations’ understanding. A separate, ongoing study is also taking place to understand which terms patients look to define online and which sites they use.

The researchers have developed their own Chrome plug-in to define words and guide users to sites approved for both reading level and reliable information. “We’re going to pilot that as a next step, and continue expanding our research to understand how broader populations are receiving this information,” said Dr. Sarah Tevis, an assistant professor of surgical oncology and Verosky’s research mentor.

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