Patient preferences for notification of normal laboratory test results: A report from the ASIPS Collaborative

Abstract

BackgroundMany medical errors occur during the laboratory testing process, including lost test results. Patient inquiry concerning results often represents the final safety net for locating lost results. This qualitative study sought to identify, from a patient perspective, specific preferences and factors that influence the process of communicating normal (negative) laboratory test results to patients.MethodsWe conducted 30-minute guided interviews with 20 adult patients. Patients were recruited from two practice-based research networks in Colorado that were participating in a medical errors study. A semi-structured interview elicited the participant's experience with and preference for laboratory test result notification. Quantitative descriptive statistics were generated for demographic and preference data. Qualitative results were analyzed by a team of experienced qualitative researchers using multiple styles of qualitative analyses, including a template approach and an editing approach.ResultsNinety percent of participants wanted to be notified of all tests results. Important issues related to notification included privacy, responsive and interactive feedback, convenience, timeliness, and provision of details. Telephone notification was preferred, followed by regular mail. Electronic notification was perceived as uncomfortable because it was not secure. While 65% preferred being notified by a provider, participants acknowledge that this may be impractical; thus, they wanted to be notified by someone knowledgeable enough to answer questions. Participants do not normally discuss their preferences for test result notification with their providers.ConclusionPrivacy, responsive and interactive feedback, convenience, and timeliness with detailed information may be critical for patient satisfaction and for improving patient safety, and are features that may be incorporated into emerging communication channels.

Patient Preferences for Receiving Reports of Test Results

“…Studies reporting a preference for US mail or telephone call reflect patients' perceptions that these are the most secure forms of communication. 11 More sensitive test results could therefore affect the degree to which patients are concerned with confidentiality. This study suggests that patients may prefer the option to choose the method of delivery of medical test results, depending on the type of test administered.…”

“…9 -11 These studies report a lack of preference in electronic methods of delivering test results, stressing a concern over the security of information with this form of communication. 10,11 However, technology has advanced remarkably, and consumers are more familiar with working with private information over the Internet. This study was conducted to gain greater insight into the general public's preferences to modes of communication between them and their health care provider with regard to specific medical test results.…”

Patient Preferences for Test Result Notification

“…Ignoring the patient safety benefits that might accrue from routinely conveying test results to patients, patients consistently report that they want to know their test results whether normal or abnormal. 17,19 For example, Baldwin and colleagues found that 90 % of patients wanted to be notified of all test results, 16 and a recent trial by Delbanco and colleagues found that providing open access to medical records was well received by patients and providers alike. 27 Several EHR developers have created patient portals, such as Epic's MyChart or the Veterans Health Administration's My HealtheVet, to meliorate communication with patients.…”

“…Our work built upon prior research that we and others have performed in this area. 10,16,17,19 We collected data on survey respondents' demographic (age, race, sex), educational attainment (categorized as high school or less, some college, completed college, and graduate school or above), and baseline health status (categorized as excellent, very good, good, fair, or poor) information. The full survey instrument is included as Appendix 1.…”

“…15 While there is growing momentum in favor of sharing test results with patients, few studies have empirically evaluated patients' preferences for receiving notification of their test results. [16][17][18] Moreover, we are unaware of any studies that have evaluated how preferences vary with patient demographics, the emotional impact of the particular test being considered, and whether the test result was normal or abnormal.…”