Should MyChart release sensitive test results immediately with an Emmie explanation, or let patients wait for clinician review?

Introduction

Under the US 21st Century Cures Act information blocking rules, health systems generally must make most test results available to patients without delay, which means many results appear in MyChart before a clinician has reviewed them. Patients appreciate fast access, but some receive alarming results, such as a cancer biopsy or abnormal scan, alone at night. Epic previewed at its 2026 user group meeting a MyChart feature letting patients chat with AI about their test results, based on a UC San Diego Health trial. The prompt: should MyChart release results immediately with an AI explanation from Emmie, or hold sensitive results briefly so clinicians can explain them first? This trade-off weighs patient autonomy and transparency against emotional harm and clinical context, within legal constraints.

Step 1

Clarifying Questions (3 minutes)

• Context: What does the law allow?

Why it matters: Information blocking rules limit delays; exceptions exist, for example when a delay prevents substantial harm to the patient, typically determined case by case. Expected answer: Health systems can't routinely delay results; patients may choose to receive results later. Impact on approach: Patient choice is a lawful lever; blanket delays are not.

• Business Context: What do health systems want?

Expected answer: Fewer distressed calls and messages, compliance with rules, and good patient experience.

• User Impact: Which results cause the most distress?

Expected answer: Pathology, oncology imaging, genetic tests and some lab results like HIV.

• Technical: Can Emmie explain results safely?

Expected answer: It can explain what a test measures and general meaning, but shouldn't diagnose or give prognosis.

• Resource: Who builds this?

Expected answer: MyChart and AI teams, plus clinical content reviewers.