Viewing Laboratory Test Results Online
Viewing Laboratory Test Results Online
Background and Objective: This study sought to extend the existing research regarding patients' reactions to viewing laboratory test results online by: (a) investigating patients' emotional responses to viewing test results online, (b) determining what, if any, followup actions patients engaged in after viewing their test results online, and (c) examining the impact of preparatory conversations between physicians and patients on patients' emotional and behavioral responses.
Methods: An email survey of Kaiser Permanente members was conducted. Study participants were patients who had viewed at least one test result online within the past year.
Results: A total of 1,546 patients responded to the survey; response rate was 43%, completion rate was 39%. Survey participants reported high levels of satisfaction, appreciation, calm, happiness, and relief. Few experienced worry, confusion, fear, upset, or anger. The most common followup activities to viewing lab test result online were speaking with family or friends about the results, looking up information on websites, and making a graph of the pattern of test results over time. Patients whose doctors spoke with them about what to expect from their test results experienced significantly more relief, appreciation, satisfaction, happiness, calm; and, less confusion than those who did not speak with their doctors prior to viewing their results. Patients whose expectations were set by their doctors were also less likely to engage in a host of followup activities, including emailing and telephoning doctors and scheduling additional appointments.
Conclusion: This study demonstrates that patients who view their lab test results online overwhelmingly react with positive rather than negative emotions. The results also illustrate the influence of physician-patient prior communication on patients' reactions and their followup actions.
Patient access to laboratory test results via online patient portals is growing across the United States and other countries. This increasing access is being accompanied by widespread concern about patients receiving results without the intermediation of physicians. Traditionally, physicians have been responsible for explaining test results to patients and putting the results into the context of the patient's entire health picture. The concerns are that: (1) patients seeing abnormal test results will react negatively with anxiety or other harmful emotional reactions; (2) patients will not understand the results, whether normal or abnormal, and will need extra time from the physician to explain what they mean. A corollary concern is that patients will be unnecessarily worried about the clinically insignificant results that fall outside of the reference range, or about expected results that fall out of this range, such as an International Normalized Ratio (INR) for a patient on an anticoagulant.
Research evidence indicates that these concerns may be unfounded. Studies have shown that for the most part patients do not react negatively to the idea of viewing their test results online, and report that they are not concerned about the privacy of those records. In a study focused on electronic access to medical records Pyper et al discovered that although some medical terms and abbreviations did require explanation, the majority of patients in their study found the content of their medical records generally useful and easy to understand. Moreover, numerous studies have demonstrated that patient satisfaction increases as patients gain greater and faster access to their medical records. None of these studies asked specifically about patients' emotional reactions and followup actions after seeing online test results.
Concerns that providing patients access to their electronic medical records will increase physician workload are unsubstantiated in the literature. Ross et al noted that merely giving patients access to their medical records did not appreciably increase workload, and in some cases increased efficiency because patient-held records were more likely to be available at the time of appointments than hospital-held records. Similarly, Rodriguez et al showed that contrary to expectations, 6 months following the implementation of an expanded offering of laboratory results on a patient portal, physicians and nurses said their workload actually decreased or stayed the same.
Although the existing literature does not support the notion that releasing laboratory test results to patients online will result in negative consequences for patients and physicians, there is still some ambiguity surrounding the potential impact of a-priori patient-physician conversations about test results. This study seeks to extend the existing evidence by: (a) investigating patients' emotional responses to viewing test results online, (b) determining what, if any, followup actions patients engaged in after viewing their test results online, and (c) examining the impact of preparatory conversations between physicians and patients on patients' emotional and behavioral responses.
Abstract and Introduction
Abstract
Background and Objective: This study sought to extend the existing research regarding patients' reactions to viewing laboratory test results online by: (a) investigating patients' emotional responses to viewing test results online, (b) determining what, if any, followup actions patients engaged in after viewing their test results online, and (c) examining the impact of preparatory conversations between physicians and patients on patients' emotional and behavioral responses.
Methods: An email survey of Kaiser Permanente members was conducted. Study participants were patients who had viewed at least one test result online within the past year.
Results: A total of 1,546 patients responded to the survey; response rate was 43%, completion rate was 39%. Survey participants reported high levels of satisfaction, appreciation, calm, happiness, and relief. Few experienced worry, confusion, fear, upset, or anger. The most common followup activities to viewing lab test result online were speaking with family or friends about the results, looking up information on websites, and making a graph of the pattern of test results over time. Patients whose doctors spoke with them about what to expect from their test results experienced significantly more relief, appreciation, satisfaction, happiness, calm; and, less confusion than those who did not speak with their doctors prior to viewing their results. Patients whose expectations were set by their doctors were also less likely to engage in a host of followup activities, including emailing and telephoning doctors and scheduling additional appointments.
Conclusion: This study demonstrates that patients who view their lab test results online overwhelmingly react with positive rather than negative emotions. The results also illustrate the influence of physician-patient prior communication on patients' reactions and their followup actions.
Introduction
Patient access to laboratory test results via online patient portals is growing across the United States and other countries. This increasing access is being accompanied by widespread concern about patients receiving results without the intermediation of physicians. Traditionally, physicians have been responsible for explaining test results to patients and putting the results into the context of the patient's entire health picture. The concerns are that: (1) patients seeing abnormal test results will react negatively with anxiety or other harmful emotional reactions; (2) patients will not understand the results, whether normal or abnormal, and will need extra time from the physician to explain what they mean. A corollary concern is that patients will be unnecessarily worried about the clinically insignificant results that fall outside of the reference range, or about expected results that fall out of this range, such as an International Normalized Ratio (INR) for a patient on an anticoagulant.
Research evidence indicates that these concerns may be unfounded. Studies have shown that for the most part patients do not react negatively to the idea of viewing their test results online, and report that they are not concerned about the privacy of those records. In a study focused on electronic access to medical records Pyper et al discovered that although some medical terms and abbreviations did require explanation, the majority of patients in their study found the content of their medical records generally useful and easy to understand. Moreover, numerous studies have demonstrated that patient satisfaction increases as patients gain greater and faster access to their medical records. None of these studies asked specifically about patients' emotional reactions and followup actions after seeing online test results.
Concerns that providing patients access to their electronic medical records will increase physician workload are unsubstantiated in the literature. Ross et al noted that merely giving patients access to their medical records did not appreciably increase workload, and in some cases increased efficiency because patient-held records were more likely to be available at the time of appointments than hospital-held records. Similarly, Rodriguez et al showed that contrary to expectations, 6 months following the implementation of an expanded offering of laboratory results on a patient portal, physicians and nurses said their workload actually decreased or stayed the same.
Although the existing literature does not support the notion that releasing laboratory test results to patients online will result in negative consequences for patients and physicians, there is still some ambiguity surrounding the potential impact of a-priori patient-physician conversations about test results. This study seeks to extend the existing evidence by: (a) investigating patients' emotional responses to viewing test results online, (b) determining what, if any, followup actions patients engaged in after viewing their test results online, and (c) examining the impact of preparatory conversations between physicians and patients on patients' emotional and behavioral responses.
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