Patients Prefer Web Access to Test Results

Patients increasingly prefer to receive laboratory test results via password-protected websites and portals, according to a study published in the Journal of the American Board of Family Medicine. Password-protected websites and portals are even more preferred with increased perception of test result sensitivity.

“It is necessary for health professionals to deliver results using the most confidential and patient-oriented method possible,” write the Georgetown University Medical Center-based authors. “Despite these needs, no standardized delivery method has been established, nor have preferences been clearly delineated.” Determining patient communications preferences is difficult given both how rapidly technology is evolving and how quickly patients adapt to these new communication methods. The authors acknowledge that while return of results must be Health Insurance Portability and Accountability Act-compliant, Internet-and mobile-based communication have dramatically increased since the law’s passage in 1996, and this changing technological environment may not be fully captured in regulations.

For example, in 2014, the Department of Health and Human Services began requiring laboratories to provide patients direct access to results and permits use of patient portals; the agency does not require, however, results be returned electronically. The Georgetown study utilized electronic surveys to evaluate patient demographics, familiarity with certain medical tests, and patient’s hypothetical preferences for delivery of medical test results. Preferences were assessed for common tests (cholesterol and colonoscopy) and for more sensitive ones (sexually transmitted infections [STIs] and genetic tests). The seven communication methods analyzed were: fax, mobile and home voicemail, e-mail, letter, mobile phone text message, and password-protected website. In-person communication was not measured.

Results were based upon responses from 409 participants (255 women; average age 37 years old; 88 percent white). For return of common test results more than 50 percent of respondents reported feeling comfortable with four of the seven communication methods (password-protected website, personal voicemail, personal E-mail, and letter). However, for STIs, more than 50 percent of participants only felt comfortable with password-protected websites. For genetic test results, no method garnered majority support, although password-protected websites were most preferred (46 percent). Overall, participants were least comfortable receiving any results (common or sensitive test results) via fax and home voicemail. Interestingly, preference for returning results via personal e-mail and password-protected website preferences were not affected by age. However, differences in comfort for receiving results via mailed letter were related to age (71 percent of participants over age 55 versus 35 percent of participants ages 18 to 24 years). “Communication with patients may need to be on a case-by-case basis—every individual may have a personal preference, and there may be a way to indicate those preferences in the patient’s record,” said lead author, Jeannine LaRocque, Ph.D., from Georgetown’s School of Nursing and Health Studies, in a statement.