Releasing test results directly to patients: A multisite survey of physician perspectives.
OBJECTIVE
To determine physician perspectives about direct notification of normal and abnormal test results.


METHODS
We conducted a cross-sectional survey at five clinical sites in the US and Australia. The US-based study was conducted via web-based survey of primary care physicians and specialists between July and October 2012. An identical paper-based survey was self-administered between June and September 2012 with specialists in Australia.


RESULTS
Of 1417 physicians invited, 315 (22.2%) completed the survey. Two-thirds (65.3%) believed that patients should be directly notified of normal results, but only 21.3% were comfortable with direct notification of clinically significant abnormal results. Physicians were more likely to endorse direct notification of abnormal results if they believed it would reduce the number of patients lost to follow-up (OR=4.98, 95%CI=2.21-1.21) or if they had personally missed an abnormal test result (OR=2.95, 95%CI=1.44-6.02). Conversely, physicians were less likely to endorse if they believed that direct notification interfered with the practice of medicine (OR=0.39, 95%CI=0.20-0.74).


CONCLUSIONS
Physicians we surveyed generally favor direct notification of normal results but appear to have substantial concerns about direct notification of abnormal results.


CONCLUSIONS
Widespread use of direct notification should be accompanied by strategies to help patients manage test result abnormalities they receive.
Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Graduate College of Social Work, University of Houston, Houston, TX, USA. Electronic address: traberd@bcm.edu.
Traber Davis
TD
Giardina
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Joanne
J
Callen
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Andrew
A
Georgiou
Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Johanna I
JI
Westbrook
Kelsey Research Foundation, Houston, TX, USA.
Anthony
A
Greisinger
CHI St. Luke's Health, Department of Clinical Effectiveness & Performance Measurement, Houston, TX, USA.
Adol
A
Esquivel
Department of Family & Community Medicine, Baylor Scott & White Health, College of Medicine, Texas A&M Health Science Center, Temple, TX, USA.
Samuel N
SN
Forjuoh
Graduate College of Social Work, University of Houston, Houston, TX, USA.
Danielle E
DE
Parrish
Houston Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Hardeep
H
Singh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001315:Australia; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine; D030881:Disclosure; D057286:Electronic Health Records; D005260:Female; D006761:Hospitals; D006801:Humans; D008875:Middle Aged; D033283:Patient Access to Records; D058007:Physicians, Primary Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States
Direct notification; Patient access to medical information; Test result notification