Should cancer diagnoses come from the patient portal? 75% say no.

Do patients prefer cancer diagnoses via the patient portal?

The researchers surveyed more than 2,400 individuals who'd been diagnosed with cancer at UT Southwestern's Harold C. Simmons Comprehensive Cancer Center, asking how they learned about their cancer diagnosis and who they'd like to get test results in the future.

Notably, most of the respondents learned of their cancer diagnosis through a conversation with their healthcare provider. This is unsurprising, as the survey included individuals diagnosed with cancer between 2019 and 2023, and the Cures Act provisions requiring immediate access to test results didn't roll out until 2022.

But according to the survey, those individuals would like the same exact process for receiving test results again in the future. Overall, 75% of respondents said they want to receive cancer diagnoses from a provider, not a patient portal notification. Of those respondents, 48% wanted the diagnosis to come during an in-person visit, while 27% were okay with a telehealth visit.

Respondents might have been biased by their previous experiences.

Because most of the respondents had received their first cancer diagnosis from a healthcare provider, they may have selected the option they were accustomed to. Indeed, among respondents who received their initial cancer diagnosis via the patient portal, 54% preferred this method again compared to 42% who wanted to hear from their doctor.

There are consequences to immediate resulting, especially when a patient awaits potentially bad news and would prefer to hear from a clinician.

For example, of the individuals who received their first cancer diagnosis through the patient portal, 59% were alone. While this might have been some respondents' preference, others might have found comfort in learning the news alongside a loved one or trusted clinician.

"That's one of the most unintended consequences of real-time access," Dr. Bhalla said. "Patients are often alone without support from their physician or family at one of their most vulnerable moments."

Personalizing patient access to test results

Fortunately, there are a few solutions to this problem.

Notably, healthcare providers and the IT developers designing patient portals should create pathways for more individualized care, according to David Gerber, M.D., the study's senior author.

"These findings highlight the need for a more personalized, tailored approach to communicating sensitive and life-changing results," Gerber said in a press release. "Moving beyond a one-size-fits-all approach can help clinicians provide a more thoughtful, compassionate patient experience."

For example, clinicians can caution patients that they might get their test results before the clinician can review them. They can also offer to send a patient portal message to patients once the results have been viewed and set up a time to discuss them.

Patient portals and EHRs that support patient data access can also enable more personalized care delivery. For example, portal developers might create different notification settings based on patient preferences or the type of test being run. Technology should also include plain-language explanations of test results to help patients parse the meaning behind a positive or negative result.

Does healthcare need a policy fix?

Importantly, immediate patient data access was mandated by federal law under information blocking provisions in the 21st Century Cures Act. Although the UT Southwestern researchers recommended key workarounds to help ensure patient preferences are met when folks receive potentially upsetting news, health policy would need to back it up.

Earlier this year, the trade group AMGA sent a letter urging the Office of the National Coordinator for Health IT to establish guardrails for the information blocking rule. This comes as HHS has promised sharper enforcement of the rule.

"We ask ASTP to reconsider its interpretation that any delay, even for a matter of hours, constitutes 'interference' absent an immediate threat of physical harm," Jerry Penso, M.D., president and CEO of AMGA, wrote in an October 2025 letter to ASTP/ONC. "Emotional and mental harm caused by patients learning devastating diagnoses without provider support is real, profound, and should be recognized in federal regulation."

AMGA called for many of the same changes the UT Southwestern researchers did -- interpersonal and IT-supported mechanisms for tailoring delayed resulting for sensitive tests.

Patient data access is important, the trade group stressed. However, it called for more flexibility to support the mental and emotional well-being of individuals awaiting upsetting or surprising news.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.