A decade ago, most patients were informed over the phone or in person by the doctors. But in the past few years, hospitals and medical practices have urged patients to sign up for portals, which allow them rapid, round-the-clock access to their records. Lab tests are now released directly to patients.

The push for portals has been fueled by several factors: the widespread embrace of technology, incentive payments to medical practices and hospitals that were part of 2009 federal legislation to encourage “meaningful use”of electronic records, and a 2014 federal rule giving patients direct access to their results. Policymakers have long regarded electronic medical records as a way to foster patient engagement and improve patient safety.

Are portals delivering on their promise to engage patients’? Or are these results too often a source of confusion and alarm for patients and the cause of more work for doctors because information is provided without adequate—or sometimes any—guidance?

Although what patients see online and how quickly they see it differs—sometimes even within the same hospital system—most portals contain lab tests, imaging studies, pathology reports and less frequently, doctors’ notes. It is not uncommon for a test result to be posted before the doctor has seen it.

Katharine Tread way, an internist, knows what it’s like to obtain shocking news from an electronic medical record. The experience, she said, has influenced the way she practices. More than a decade ago—long before most patients had portals—Treadway, with her husband’s permission, pulled up the results of his MRI scan on a hospital computer while waiting to see the specialist treating his sudden, unbearable arm pain.

“It showed a massive tumor and widespread metastatic disease, “Treadway recalled. She never suspected that her 59-year-old husband had cancer, let alone a highly aggressive and usually fatal form of advanced lymphoma.

Treadway, whose husband has been cancer-free for more than a decade, said she remembered intently checking the name and date of birth, certain she had the wrong patient, then rebooting the computer several times “like I was going to get a different answer.”

What is the trend mentioned at the beginning of the passage?