Patients Struggle to Understand Test Results Viewed on EHRs

Although, broader adoption of electronic health records has given patients access to their lab results online, a new study indicates people may not understand what they are seeing.

One of the purposes of giving patients access to test results outside of a doctor’s visit is to help them become partners in managing their care, according to lead author Brian Zikmund-Fisher. However, he and his fellow researchers found patients with low numeracy (comprehension of numerical concepts) and low literacy skills were much less likely to understand if results were inside or outside the reference ranges.

"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," Zikmund-Fisher, a professor at the University of Michigan, said in a statement. "The problem is, many people can't imagine that giving someone an accurate number isn't enough, even if it is in complex format."

The investigators asked more than 1,800 adults between the ages of 40 and 70 years were given shown test results for hemoglobin A1c as well as tests to measure their numeracy and health literacy skills. The participants were asked to respond as if they had diabetes (although, nearly half actually had the disease).

According to the results, 77% of people with higher health literacy and numeracy correctly identified levels outside of the range, while just 38% of participants with lower health literacy and numeracy were able to do so. Those with higher literacy and numeracy were also more sensitive to how high the test result was when deciding to call the doctor.

"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," Zikmund-Fisher said. "In fact, improving how we show people their health data may be a simple but powerful way to improve health outcomes."