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Online lab test results may not be understandable to patients


EHR patient portals allow patients to view their lab results online, but a new study questions whether they'll be able to decipher them.

The growing adoption of electronic health records (EHRs) is giving increasing numbers of patients online access to test results, but they may not be able to decipher their meaning, according to a new study.

Researchers at the University of Michigan’s schools of Public Health and Medicine found that people with low comprehension of numerical concepts and low literacy skills were less than half as likely to understand whether a result was inside or outside reference ranges, and also less able to use the data to decide whether to call their doctor.

READ: EHR adoption outpaces HIE patient engagement

A new, more intuitive format might be needed in the future to make results easier to understand, said Brian Zikmund-Fisher, Ph.D.,associate professor of health behavior and health education at the university’s School of Public Health.

Access to test results is steadily increasing with the growing adoption of EHRs by medical facilities and providers, and one goal of increased access is to help patients become partners in managing their own healthcare, said Zikmund-Fisher.

But, he adds, "We can spend all the money we want making sure that patients have access to their test results, but it won't matter if they don't know what to do with them."

The results of the study were based on an Internet survey of 1,800 adults aged 40 to 70. Respondents were asked to answer questions as if they had Type 2 diabetes. (Nearly half actually had the disease).

Tests were given to participants to measure their numeracy and health literacy skills. Displays were shown for hemoglobin A1c, commonly measured to check blood sugar levels, as well as other blood tests.

The survey found that while 77% of those considered to have higher numeracy and literacy skills could identify levels outside of the standard range, only 38% of those with lower numeracy and literacy scores were able to do so. Participants with higher numeracy and literacy scores also were more sensitive to the test results  when deciding whether to call their doctor.

Next: More research is needed


Zikmund-Fisher said more research is needed to identify how best to display this type of information, noting that as of now, “many people can't imagine that giving someone an accurate number isn't enough, even if it is in complex format."

"If we can design ways of presenting test results that make them intuitively meaningful, even for people with low numeracy and/or literacy skills, such data can help patients take active roles in managing their health care," he said.

The research was reported online in the Journal of Medical Internet Research.

More about EHRs:

Physician outcry on EHR functionality will shake the health information technology sector

(Slideshow) Medical Economics EHR survey probes physician angst about adoption, use of technology

EHRs not fulfilling promise of improved healthcare delivery

Top 10 most popular EHR systems for small practices

EHR best practices: Pre-implementation

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