Information Overload and the Portal Patient: Managing Physician–Patient Relationships in the Era of Instant Test Results

The way that patients receive medical information has changed dramatically. Through electronic health record portals, laboratory values, imaging reports, and pathology results often become available the moment they are finalized—sometimes before a physician has had the opportunity to review or discuss them. While this unprecedented access promotes transparency and patient engagement, it also creates new challenges for communication, trust, and anxiety management. In the latest episode of Oncology Unfiltered, Melissa Cutrona, Co-Founder and General Manager of i3 Health and Oncology Data Advisor, sits down with Matthew Hadfield, DO, Oncology Data Advisor Editor in Chief, to explore how instant access to test results is reshaping oncology care.

Instant Information Without Context

Although patient portals have existed throughout Dr. Hadfield's medical career, he notes that their widespread adoption has fundamentally changed how patients experience waiting for results. "Patients get results, but they're not in any sort of context," Dr. Hadfield explained. "There's oftentimes a gap between what the results say and the level of understanding the patients or their family have. I sometimes find that it causes more anxiety than good."

That anxiety isn't limited to bad news. Even reassuring findings can become sources of stress when patients are left to interpret technical medical language on their own.

When Medical Language Creates Fear

Radiology and pathology reports are written primarily for healthcare professionals, not patients. As a result, reports often include highly detailed observations that are clinically routine but can sound alarming to someone reading them for the first time.

Dr. Hadfield described a common scenario: a patient undergoes surveillance imaging after surgery for melanoma, and the radiologist notes a "4 mm nonspecific pulmonary nodule." For clinicians, this may simply indicate an insignificant finding that warrants routine follow-up according to established guidelines. For patients, however, an internet search linking "pulmonary nodule" and "melanoma" can quickly lead to frightening—and often inaccurate—conclusions.

"The report oftentimes won't say explicitly, 'This is not metastatic disease,'" he said. "Patients read this, they Google melanoma and pulmonary nodule, and they inevitably end up somewhere where it says they're going to die or have a horrible outcome." Without clinical context, isolated pieces of information can become much more frightening than they deserve to be.

Navigating Difficult Results Before the Appointment

One of the greatest challenges of immediate portal access occurs when significant or life-changing results become available before a scheduled visit. Whenever possible, Dr. Hadfield tries to personally call patients after reviewing particularly difficult findings. However, he acknowledges that this is not always feasible given the volume of results that physicians review each day.

Instead, he emphasizes setting expectations early. "I explain to patients that it's better to talk in person at the next appointment," he said. "Typically, I see patients frequently enough where it's not going to be very long until they're coming to clinic after I've ordered a test like this." Clear communication about how results will be discussed can help reduce uncertainty during what is often an emotionally charged waiting period.

More Information Isn't Always Better

Patients today have access not only to their medical records but also to nearly limitless online resources and increasingly sophisticated AI tools. While this wealth of information can be empowering, Dr. Hadfield believes that information alone is rarely enough.

"Challenges arise when the information is coming so quickly without any context," he explained. "When you get an isolated result and then you Google it, you're not going to get recommendations for your specific cancer and your specific situation.” Every patient's diagnosis, treatment history, biology, and goals are unique. General information—even when accurate—cannot fully account for those individual factors that ultimately guide clinical decision making.

Building Trust Through Conversation

When patients become worried about a particular phrase or abnormal value in a report, Dr. Hadfield believes the answer is not dismissal but conversation. "The most important thing is trust between patients and physicians," he said. "If someone's concerned because they saw something on a scan or in a pathology report, then you need to spend more time talking about it with them."

Even seemingly insignificant laboratory abnormalities can become distressing when presented without explanation. Patient portals often flag values outside the laboratory's reference range with bright warning indicators, even when the abnormality is clinically insignificant. Dr. Hadfield offered the example of a sodium level measuring 130 when the laboratory's normal range end at 129.

"I look at it quickly and say there's completely nothing here to worry about," he explained. "But those red exclamation points always look scary to patients." Rather than minimizing those concerns, he encourages clinicians to explain why certain abnormalities are meaningful while others are not.

Transparency Is Not One Size Fits All

While some patients want immediate access to every available piece of information, others find constant updates emotionally overwhelming. Dr. Hadfield believes both approaches are valid.

He compared this dynamic to conversations surrounding circulating tumor DNA monitoring, where additional testing can provide more information but may also create additional anxiety. "Some patients are like, 'I don't want more information because I'm just going to stress about it,'" he said.

For those patients, he sometimes discusses whether using the patient portal itself is beneficial. "If you don't have the portal, it's not as if we're not looking at your results," he explained. "If they're abnormal or something needs to be worked on, we're going to take care of it." Ultimately, he believes access preferences should be individualized rather than universally prescribed.

An Informed Patient Is Often a Better Partner

Despite the challenges posed by information overload, Dr. Hadfield is encouraged when patients arrive having researched their diagnosis and treatment options. "Honestly, I think that's good," he said. "I think it's great when people are active and want to learn more about the disease." He particularly recommends well-vetted resources provided by patient advocacy organizations, which often offer reliable educational materials, clinical trial information, and support communities.

Although physicians bring years of specialized experience to treatment decisions, engaged patients contribute valuable questions and perspectives that can strengthen their involvement in their care. "I think on the whole, it's a really good thing," he said. "It helps the informed consent process.”

The Growing Burden of Digital Communication

Patient portals have also transformed communication itself. Secure messaging allows patients to reach their care teams more easily than ever before—but it also creates substantial new demands on clinicians who are already managing busy practices.

At Dr. Hadfield’s institution, nursing staff help triage incoming portal messages, addressing routine questions while escalating more urgent concerns to physicians when appropriate. Even so, the growing volume of digital communication remains an ongoing challenge across healthcare. “The workflow in terms of responding to messages and addressing concerns that are non-urgent is something that, as a healthcare community, we’re all trying to grapple with,” he said.

Conclusion

Ultimately, Dr. Hadfield believes that the strongest tool for navigating this evolving landscape is proactive communication. "I think everything is always going to be improved by clarifying expectations between providers and patients," he said. Establishing clear expectations about when patients should anticipate communication—and when they should not—helps reduce unnecessary anxiety while preserving trust.

As oncology continues to evolve alongside increasingly connected technology, both physicians and patients are learning to balance immediate access with thoughtful interpretation. Information itself is rarely the problem. Rather, as Dr. Hadfield emphasized, information becomes most valuable when accompanied by context, communication, and a trusted therapeutic relationship.

Key Takeaways

Patient portals have transformed oncology care by giving patients immediate access to test results, but information without context can often increase anxiety rather than provide reassurance.
Radiology, pathology, and laboratory reports are written for clinicians and may contain technical language or incidental findings that sound alarming despite having little or no clinical significance.
Open communication and clear expectations are essential. Letting patients know when and how results will be discussed can help reduce uncertainty and unnecessary worry.
Transparency should be individualized. While some patients appreciate immediate access to all of their health information, others may prefer to wait until results can be reviewed with their care team.
An informed patient is an empowered patient. Researching a diagnosis and asking questions can strengthen shared decisionmaking, especially when patients rely on credible, evidence-based resources.
The growing use of patient portals has increased communication demands on oncology teams, making effective message triage and workflow management increasingly important.
Trust remains the foundation of the physician–patient relationship. Taking patients' concerns seriously, providing context, and explaining the reasoning behind clinical decisions are critical to navigating the era of instant access to medical information.