IOWA CITY, IA —With patients increasingly seek care across multiple health care settings, partly fueled by implementation of the MISSION Act, a key coordination issue is the unnecessary duplication of laboratory across different healthcare settings.

Iowa City VA Healthcare System researchers sought to examine the association between patient portal use and duplication of laboratory testing among veterans who are dual users of VA and non-VA providers. Results were published in the Telemedicine Journal and E-Health.1

To do that, researchers used a national sample of veterans who were newly authenticated users of the healthcare system’s internet portal during fiscal year 2013. The focus was on patients who used the Blue Button application at least once, compared with a random sample of veterans who were not registered to use the portal.

From these two groups, researchers were able to identify veterans who also were Medicare-eligible users in FY2014. For purposes of the study, duplicate testing was defined as receipt of more than five hemoglobin A1c assays in a year.

The study team determined that use of the Blue Button decreased the odds of duplicate HbA1c testing in VA and Medicare-covered facilities across three comparisons:

  • Overall, between users and nonusers: Portal users were less likely to have duplicate testing;
  • Pre-post comparison: There was a trend toward lower duplicate testing in both groups across time; and
  • Pre-post comparisons accounting for use of the portal: The trend toward lower duplicate testing was greater in Blue Button users. 

“Duplicate HbA1c testing was significantly lower in dual users of VA and Medicare services who used the Blue Button feature of their VA patient portal,” the authors concluded. “Non-VA providers encounter barriers to access of complete information about Veterans who also use VA health care. Provider endorsement of consumer-mediated health information exchange could help further this model of sharing information.”

  1. Wakefield BJ, Turvey C, Hogan T, et al. Impact of Patient Portal Use on Duplicate Laboratory Tests in Diabetes Management [published online ahead of print, 2020 Feb 11]. Telemed J E Health. 2020;10.1089/tmj.2019.0237. doi:10.1089/tmj.2019.0237