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Patients' Preferences for Receiving Laboratory Test Results
Azam Sabahi, BS; Leila Ahmadian, PhD; Moghadameh Mirzaee, PhD; and Reza Khajouei, PhD
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Patients' Preferences for Receiving Laboratory Test Results

Azam Sabahi, BS; Leila Ahmadian, PhD; Moghadameh Mirzaee, PhD; and Reza Khajouei, PhD
The main reason given for receiving results online was time savings, reported by 77% of participants, followed by lowering the chance of missing the results (31%).
To our knowledge, there is no previous study in Iran that has investigated patient preferences regarding the delivery of test results. Most studies done in other countries have evaluated the perspective of special groups of patients, such as those with HIV20,23 or those with sexually transmitted diseases.19,21 Some other studies have evaluated security and confidentiality factors into preferences24 and patient priorities for sending normal test results.25 Our study investigated the preferences of a general population of patients who had been referred to a hospital laboratory, regarding the results of all tests.

The findings of our study show that the participants believed that the most useful method for communicating laboratory test results was providing the results to those with internet access through e-mail or website services. Frequent internet users had less confidence in the process of receiving test results via a website. However, although the result was not significant, patients expressed that sending the test results via e-mail was the most satisfactory and confidential notification method.

The findings of a study done by Platteau and colleagues23 that questioned 898 men from Belgium who have sex with men showed a high level of satisfaction among the participants for receiving their HIV test results online. Findings by Shirts and colleagues24 about 96 US participants (48 physicians and 48 nurse practitioners working in the nursing home setting) also indicated that they would be willing to try a Web-based system to get their patients’ test results if they were convinced of its security and confidentiality. The results of another study done in South Carolina and Mississippi in 2009 and 2010 also indicated that this method of communicating test results would accelerate the treatment process.19

In other available research, the most important features of the communicating system for test results, from the perspective of the participants, were the timeliness and confidentiality of the data. The results of interviews with 20 Colorado patients, and of a study of 171 women from the United Kingdom with breast cancer who were asked about methods of receiving breast biopsy results, also show that when receiving test results electronically, their timely receipt is highly important to the patients.25,26

In other studies, respondents noted that receiving detailed information along with test results online was important when receiving Pap smear results and for gastroenterologists who were communicating endoscopy findings.27,28 Providing identification information with their test results was also favored by our study participants, likely because they want assurance that they received the correct test results. This finding suggests that although patients worry about confidentiality, they also consider potential mishandling of the information.

Healthcare institutions should consider their patients’ confidentiality concerns and be sure an effective and efficient identification plan is established and maintained in all patient communication systems. An admission code is also among the data that patients would request, perhaps because they believe that this code gives them the chance to track their results more effectively.

In the Colorado study by Baldwin and colleagues,25 the 20 patients were less enthused about getting test results online because of security concerns. Only 10% of those patients chose e-mail for receiving their results, which is not in line with the current findings. This difference might be because in the current study, when patients asked about confidentiality issues, the researcher explained the details of the approach the laboratory department intended to use in e-mailing test results. The patients were told they would be issued an ID number when initially taking the test and that individualized number would need to be entered to see the test results. With such an approach, unauthorized persons cannot easily access the data. However, the acceptability and feasibility of this approach should be studied.

The findings of Siedner and colleagues20 on 50 HIV-infected patients from rural Uganda showed that although communication of information about HIV laboratory test results via text messages would be acceptable, a few patients also expressed concerns about confidentiality, mentioning they might be more comfortable with both coded messages and PIN codes to protect confidentiality.

The results of our study confirmed the results of others that indicated patients’ tendency to wish to receive their normal and abnormal test results through different technologies.19,25,29,30

In our study, the main reason given by patients for wanting to receiving test results online was to save time; this is not in line with the findings of the study of Sieder et al,20 in which patients were most interested in decreases in transportation costs. This difference can be explained by the significance of the research location. Since the city of Ferdows is relatively small, its roads are close together, and city travel is easily accomplished; transportation cost reductions got less attention from participants. Results of 2 other studies that used text messaging for communicating positive Chlamydia trachomatis test results in London and New Zealand indicated that the most significant achievement of sending laboratory results electronically was cost-effectiveness.31,32

Receiving a text message reminder via cellphone on the date of receipt of laboratory results was selected by 98% of the participants. The results of a study by Lester and colleagues33 of 111 patients at 2 primary HIV care clinics in Kenya also showed that the widespread availability of mobile phones and their ease and speed of use were the reasons this technology drew the attention of the majority of participants. The results of Siedner and colleagues20 showed that all participants desired to receive their test results through text message.

Most (almost 75%) of our participants mentioned that in their previous encounter, when they arrived at laboratory department, they had to wait either 5 to 15 minutes or 15 to 30 minutes to receive their test results. In the results of the study by Zare Mehrjerdi and colleagues, this time was about 106 minutes for 150 patients referred to the emergency department in an Iranian public hospital.11 The time difference might be related to the allocation of personnel at Ferdows’ hospital and how the test results are delivered in 2 working shifts there. The results of a controlled before-and-after study regarding implementation of a computerized pathology order-entry system in an inpatient setting, and the results of a randomized trial in outpatient offices both showed that using information technology in the laboratory department can facilitate the working process and reduce the time it takes to deliver test results to patients.34,35

Recent studies evaluating laboratory information systems in hospitals of 2 large medical universities in Iran showed that using such technologies could provide better patient–provider communication, especially when the recommended standards are applied during the design and implementation of the system.7,36

Limitations

One limitation is that this research was done in a small, easy-to-navigate city, so patients had not spent a lot of money and time in their previous encounter to get their test results manually. Another limitation is that although using technology for sending the results was acceptable to most of them, they did mention that when printing was required, lack of access to a printer to print their test results was a barrier.

CONCLUSIONS

This study showed the positive attitudes of patients toward receiving their laboratory test results electronically. However, patients are concerned about the confidentiality of their data. Therefore, obtaining their consent should be considered before using such technology, and security measures should be defined to protect privacy and to gain the trust of patients.

Acknowledgments

The authors would like to thank the participating patients who devoted their time to participate in the study. They also would like to thank laboratory department personnel for their cooperation.

Author Affiliations: Ferdows Chamran Hospital, Birjand University of Medical Sciences, South Khorasan, Iran (AS); Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (LA, RKH); Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran (MM).

Source of Funding: None.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (AS, LA, MM, RK); acquisition of data (AS); analysis and interpretation of data (); drafting of the manuscript (AS); critical revision of the manuscript for important intellectual content (LA, RK); statistical analysis (MM); provision of patients or study materials (AS); administrative, technical, or logistic support (MM, RK); and supervision (LA).

Address Correspondence to: Leila Ahmadian, PhD, Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haftbagh Highway, 7616911313 Kerman, Iran. E-mail: ahmadianle@yahoo.com. 
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