Journal of General Internal Medicine

, Volume 30, Issue 11, pp 1698–1698 | Cite as

Capsule Commentary on Shultz et al., Patient Preferences for Test Result Notification

  • Holly O. Witteman
Capsule Commentary


False Alarm Health Data Data Security Laboratory Test Result Health Information Technology 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Shultz and colleagues1 report findings from a survey of patients regarding ways that they might prefer to receive a variety of laboratory test results. Responses varied between and within participants, depending on factors such as the type of test, whether the hypothetical result was normal or abnormal, and participant age.

This study is set against a background of concerns about overuse of tests, tensions between data security and user convenience, and efforts to increase patient access to health care and health data.

Overuse of tests is not routinely discussed in the context of patient access to test results, but as access expands, so will opportunities for offering information from resources such as the Choosing Wisely initiative.2

Shultz and colleagues highlight the trade-offs between user convenience and data security. Participants generally preferred “secure email” over “unsecure email,” but it is unclear whether all participants understood the implications of such preferences. Survey materials described secure email as “password protected to insure confidentiality of data,” somewhat glossing over encryption procedures. Addressing tensions between convenience and security is critical for realizing the potential of health information technology.

Not addressed in this paper are similar tensions between mode and timeliness of results delivery. Telephone calls and office visits were popular options. However, waiting for test results can be nerve-racking for patients,3 and preferences might shift if an appointment required waiting for weeks, whereas results were viewable on a patient portal within days.

Patient access to health data, appropriately, is increasing. Yet not everyone feels comfortable with patients directly accessing their laboratory test results. There are some legitimate concerns about the lack of interpretability of current test result formats4 or about test results causing false alarms or false comfort. However, such worries might benefit from some historical context: similar concerns were raised about home pregnancy tests nearly 35 years ago.5

As Shultz and colleagues argue convincingly, assessing patients’ preferences is important for determining which technological system to prioritize for implementation. However, variability in participant responses suggests that the goal of providing test results in ways that suit patients might be best achieved by offering all feasible options and letting patients choose.


Conflict of Interest

The author has no conflict of interest with regard to any of the material in this manuscript.


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    Shultz SK, Wu R, Matelski JJ, Lu X, Cram P. Patient Preferences for Test Result Notification. J Gen Intern Med. 2015. doi: 10.1007/s11606-015-3344-0.PubMedGoogle Scholar
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    McMahon LF, Beyth RJ, Burger A, Chopra V, Feldstein D, Korenstein D, et al. Enhancing Patient-Centered Care: SGIM and Choosing Wisely. J Gen Intern Med. 2013;29(3):432–3.PubMedCentralCrossRefGoogle Scholar
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    Kolata G. Sick and Scared, and Waiting, Waiting, Waiting. The New York Times. 1st ed. New York, NY; 2005 Aug 20;A1:3.Google Scholar
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    Zikmund-Fisher BJ, Exe NL, Witteman HO. Numeracy and literacy independently predict patients' ability to identify out-of-range test results. J Med Internet Res. 2014;16(8):e187.PubMedCentralCrossRefPubMedGoogle Scholar
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    Pregnancy testing. Br Med J. 1971;4(5785):444–5.Google Scholar

Copyright information

© Society of General Internal Medicine 2015

Authors and Affiliations

  1. 1.Department of Family and Emergency Medicine, Office of Education and Continuing Professional DevelopmentLaval UniversityQuébecCanada
  2. 2.Public Health and Optimal Health Practices Research UnitResearch Center of the CHU de QuébecQuebec CityCanada

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