A study led by researchers at New York University’s School of Global Public Health found that 68.6 percent of US adults who received a medical test result in the previous year viewed it before hearing from a health care provider. The analysis, published in JAMA Network Open, examined how patients’ decisions to open results and their ability to understand them varied according to factors such as age, income, digital health literacy, chronic illness, geography, and experiences communicating with medical professionals.

The findings emerge from the digital-access requirements of the 21st Century Cures Act, a US law designed in part to make electronic health information more readily available to patients. Under the policy, hospitals and clinics generally release test results to patient portals as soon as they become available, rather than holding them until a clinician has reviewed the information with the patient. The change was intended to give people greater control over their health data, but it also altered the order in which information and explanation arrive. A patient may now read a radiology report or see an abnormal laboratory value before a professional has provided context.

“The Cures Act has restructured the traditional pathway between the release of a test result to a patient-clinician discussion,” said Jemar Bather, assistant professor of biostatistics at NYU School of Global Public Health and lead author of the study. “We wanted to understand whether a patient’s probability of accessing test results—and understanding of them—varies based on sociodemographic characteristics, health status, patient-centered communication, and digital health literacy.”

The researchers analyzed responses from 4,982 adults who participated in the 2024 Health Information National Trends Survey, a nationally representative survey collected by the National Institutes of Health. All of the respondents had access to electronic medical records and reported receiving a test result during the preceding year. When weighted to reflect the US population, the sample represented nearly 175 million adults. Because the study used survey data collected at one point in time, it can identify patterns and associations but cannot prove that any single characteristic directly caused a patient to view or understand a result.

People who opened their results before hearing from a provider were more likely to be older and female, to have higher incomes, and to live with multiple chronic health conditions. They also tended to report stronger digital health literacy and more frequent use of social media for health-related information. Digital health literacy refers to the ability to find, access, evaluate, and use health information through digital tools. It includes more than knowing how to log into a portal: patients must also recognize medical terminology, judge the reliability of explanations, understand uncertainty, and decide when professional advice is needed.

Among those who viewed their results immediately, comprehension was uneven. Only 6.6 percent said they understood the results poorly, but 26.8 percent reported understanding them fairly well, 31.7 percent understood them well, and 34.9 percent understood them very well. These categories reflect patients’ self-assessments rather than an objective test of medical knowledge. Even so, the distribution indicates that a sizable minority may be reading important clinical information without feeling fully confident about what it means, whether a result is serious, or what action should follow.

The least confident patients were more likely to live in the Midwest or South and to report having experienced discrimination in medical care. By contrast, higher digital health literacy was associated with better understanding. Patient-centered communication showed a similar relationship. Respondents who felt that clinicians explained information in ways they could understand and involved them in decisions were more likely to report comprehending their test results. The pattern suggests that portal design cannot be separated from the broader relationship between patients and health professionals: an understandable result is not merely a technical product, but part of an ongoing communication process.

The researchers say health systems have largely focused on delivering data, while devoting less attention to how that data is translated into useful meaning. A numerical value may appear alongside a reference range without explaining why it was ordered, how much variation is normal, or whether the result should be interpreted alongside symptoms, medications, previous measurements, or other tests. An imaging report may contain precise clinical language that is familiar to specialists but confusing or alarming to the person being examined. Tools that summarize results in plain language, explain technical terms, show trends over time, and allow patients to submit follow-up questions could help bridge the gap. Artificial intelligence may eventually support some of these functions, although any automated explanation would need safeguards, clinical oversight, and clear warnings that it is not a diagnosis.

“Health systems give you your data, but that does not mean that they put a lot of effort into making the information easy to understand on your own,” said study author José Pagán, professor and chair of NYU’s Department of Public Health Policy and Management. “Health systems and online patient portal developers should look for innovative ways to improve how they communicate—for instance, using AI to summarize test results in plain language and provide easy means for follow-up questions.” The authors emphasize that expanded access remains valuable, but access without interpretation can leave some patients behind. As immediate release becomes standard practice, the next challenge may be ensuring that every patient receives not only a result, but also the context and support needed to understand it.

Subject of Research: Patient access to and comprehension of immediately released medical test results

Article Title: Patient Viewing and Comprehension of Immediately Released Test Results

News Publication Date: 18-Aug-2026

Web References: https://doi.org/10.1001/jamanetworkopen.2026.30698

References: Bather J, Pagán JA, Goodman M, et al. “Patient Viewing and Comprehension of Immediately Released Test Results.” JAMA Network Open. Published 18 August 2026. DOI: 10.1001/jamanetworkopen.2026.30698

Keywords: patient portals, electronic health records, medical test results, digital health literacy, patient-centered communication, health care access, health information technology, 21st Century Cures Act, medical communication, health equity

Emerging research spearheaded by Giummarra and colleagues provides a comprehensive analysis of health service websites worldwide, focusing specifically on their accessibility for individuals recovering from a stroke. The study, published in the International Journal for Equity in Health, brings into sharp relief the disparities that exist between the promise of digital health equity and the reality experienced by millions who need these resources most. This investigation goes beyond simplistic usability metrics, employing rigorous technical assessments that consider the nuanced sensory and cognitive challenges faced by stroke survivors.

At the core of this research lies a critical question: How well do health service websites accommodate the altered cognitive processing speeds, visual impairments, aphasia, and motor control difficulties that commonly follow a stroke? Utilizing standardized frameworks such as the Web Content Accessibility Guidelines (WCAG) and stroke-specific heuristics developed in collaboration with clinical experts, the researchers dissected dozens of prominent health service platforms. Their findings underscore a stark deficit in adaptive features, signaling that many sites fail to provide inclusive environments that empower stroke survivors to independently access essential health information.

Technical analysis revealed that many websites suffer from poor contrast ratios, which render textual content illegible to users with visual field cuts or hemianopia, conditions frequently induced by stroke. Furthermore, the overreliance on multimedia elements without adequate text alternatives poses significant readability barriers for individuals with aphasia who struggle with language comprehension. Even more concerning was the lack of support for assistive technologies such as screen readers and voice navigation, tools that could dramatically improve access but are often neglected in website design.

Beyond visual and linguistic challenges, motor impairments prevalent among stroke survivors introduce further obstacles. The study highlights that many health service websites require precise mouse control or intricate gesture-based navigation routines incompatible with hemiparesis or fine motor skill loss. The absence of keyboard navigation alternatives and insufficiently spaced interactive elements exacerbate these usability issues. In a digital age where tele-rehabilitation programs and online appointment systems have become normative, such barriers critically undermine patient autonomy.

The research methodology employed a multi-dimensional approach integrating automated accessibility testing tools, manual expert reviews, and input from stroke survivors themselves. Engaging actual users in this process provided invaluable insights, revealing real-world frustrations and strategies employed to circumvent inaccessible design elements. These firsthand user perspectives enriched the technical findings, ensuring that recommendations emerging from the study are deeply grounded in lived experience rather than theoretical ideals.

One striking revelation from the collected data was the inconsistent application of accessibility standards across health services internationally. While certain websites incorporated commendable features like simplified language options, adjustable text sizes, and audio descriptions, a large proportion remained static and outdated. This heterogeneity not only reflects differing levels of institutional commitment to inclusivity but also highlights an urgent need for universal design mandates tailored specifically to cognitive and physical impairments resulting from stroke.

The implications of this study extend far beyond website aesthetics or user interface preferences; they strike at the heart of digital health equity. When stroke survivors are unable to efficiently navigate health service websites, they face increased risks of mismanagement, delayed care, and diminished quality of life. This digital divide compounds the already substantial challenges imposed by stroke, perpetuating health disparities and undermining public health goals that envision technology as a democratizing force.

Moreover, the study’s findings underscore a broader systemic failure to integrate disability-awareness into health technology development pipelines. Often, the voices of patients with acquired neurological conditions are overlooked during the conceptualization and implementation phases, leading to generic designs that do not account for specific accessibility needs. Giummarra and colleagues advocate for a paradigm shift towards participatory design models that actively involve stroke survivors and multidisciplinary specialists from the outset, fostering the creation of more responsive and equitable digital health environments.

Technological advancements offer promising avenues to address these challenges. Emerging tools such as AI-driven personalized interfaces, adaptive content delivery systems, and multimodal input recognition hold potential to transform stroke survivor experiences on health service websites. By dynamically tailoring website interactions to individual cognitive and motor profiles, these innovations could mitigate many current barriers. However, realizing this potential demands concerted collaboration among developers, clinicians, policymakers, and end-users, coupled with robust regulatory frameworks that enforce accessibility standards.

Alongside design improvements, educational initiatives targeting healthcare providers and administrators are imperative to raise awareness about the importance of digital accessibility for stroke populations. The study highlights a pervasive gap in knowledge regarding stroke-related impairments among technical teams responsible for website maintenance and content curation. Empowering these stakeholders through dedicated training programs can catalyze more inclusive practices and facilitate the continuous evolution of health service websites toward greater accessibility.

Furthermore, the research draws attention to the critical role of monitoring and evaluation processes that impose accountability for digital inclusivity. Incorporating routine accessibility audits, leveraging user feedback, and tracking equity outcome metrics can ensure that health service websites remain aligned with the evolving needs of stroke survivors. These mechanisms reinforce a culture of continuous improvement rather than static compliance, fostering enduring commitment to health equity in the digital realm.

The study by Giummarra et al. arrives at a pivotal moment as healthcare systems globally accelerate digital transformation in response to demographic shifts and unprecedented demands underscored by crises like the COVID-19 pandemic. It serves as a clarion call to embed accessibility as a fundamental pillar rather than an afterthought in this transformation. Without deliberate action, health service websites risk entrenching new forms of exclusion, depriving stroke survivors of vital information and support crucial for their recovery journeys.

In summation, this comprehensive investigation brings critical attention to the pressing issue of health website accessibility for stroke survivors. Its multidimensional analysis exposes systemic barriers that compromise equitable access and offers a roadmap for integrated, patient-centered solutions grounded in technical rigor and empathetic design. As digital platforms continue to redefine healthcare delivery, ensuring inclusivity for those affected by stroke must transition from aspiration to actionable standard, harnessing technology’s full potential to heal and empower.

Subject of Research: Accessibility of health service websites for people who have had a stroke

Article Title: How accessible are the websites of health services for people who have had a stroke?

Article References:
Giummarra, M.J., Brown, E., Rose, T.A. et al. How accessible are the websites of health services for people who have had a stroke?. Int J Equity Health 24, 112 (2025). https://doi.org/10.1186/s12939-025-02459-6

Image Credits: AI Generated