title: Patients' preferences for biopsy result notification in an era of electronic messaging methods.
abstract: OBJECTIVE
  Effective patient-physician communication is essential for optimal health care. Recent introduction of online patient portals to access test results are changing the communication landscape, but regulatory guidelines for the online release of biopsy results vary from state to state.
  
  
  OBJECTIVE
  To assess patient preferences for receiving skin biopsy results to rule out melanoma and to compare those preferences to current physicians' practices for notification.
  
  
  METHODS
  English-speaking individuals 18 years or older were recruited consecutively from melanoma clinics at 3 academic tertiary referral medical centers: University of California, San Francisco, University of Pennsylvania, and Duke University. Patients were surveyed from July 1, 2012, through July 31, 2013. A second survey of physicians at these institutions was conducted to assess physician notification practices.
  
  
  RESULTS
  A total of 301 of 305 patients agreed to participate (98.7 response rate). Most of the patients (67.1%) preferred to speak directly with their physician by telephone to receive their skin biopsy results, followed by a distant second choice (19.5%) of being notified in person at a clinic visit. Voice message or online patient portal were each the preferred method of communication for 5.1% of patients. The most important consideration for patients was a communication modality that provided test results in the most rapid manner; 51.7% wanted a method that was rapid, and 7.8% preferred a method that was not only speedy but also allowed them an opportunity to ask questions. A total of 59.5% of the study participants would choose the same communication method regardless of the biopsy results, but 40.5% preferred a different mode of notification if their biopsy results revealed a malignant tumor. Younger and more highly educated patients favored the online portal. Of 84 physicians surveyed, 47 responded (56% response rate). Physicians' overall preferred method of contacting patients aligned with patient preference for speaking by telephone (56.5%). However, for benign results, 31.2% of physicians chose to speak by telephone, whereas patients preferred voicemail (32.1%). There was physician uncertainty as to guidelines regarding communication of test results.
  
  
  CONCLUSIONS
  Patient preference has shifted from face-to-face visit to discussion over the telephone because of a desire for rapid notification. Experience with online portal delivery of results favorably inclined patients toward that modality. We recommend that patients be queried regarding their notification preference on the biopsy consent form.
authors.affiliation: Dermatology Service, Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Aditi
authors.initials: A
authors.lastname: Choudhry
authors.affiliation: Dermatology Service, Veterans Affairs Medical Center, San Francisco, California.
authors.forename: Judith
authors.initials: J
authors.lastname: Hong
authors.affiliation: Department of Dermatology, University of California, San Francisco.
authors.forename: Kim
authors.initials: K
authors.lastname: Chong
authors.affiliation: Department of Dermatology, Duke University, Durham, North Carolina.
authors.forename: Betty
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Dermatology, University of Pennsylvania, Philadelphia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hartman
authors.affiliation: Department of Dermatology, University of Pennsylvania, Philadelphia.
authors.forename: Emily
authors.initials: E
authors.lastname: Chu
authors.affiliation: Department of Dermatology, Duke University, Durham, North Carolina.
authors.forename: Kelly
authors.initials: K
authors.lastname: Nelson
authors.affiliation: Dermatology Service, Veterans Affairs Medical Center, San Francisco, California2Department of Dermatology, University of California, San Francisco.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Wei
authors.affiliation: Department of Dermatology, University of California, San Francisco.
authors.forename: Tien
authors.initials: T
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D017677:Age Distribution; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D001706:Biopsy; D015331:Cohort Studies; D030881:Disclosure / Q000706:statistics & numerical data*; D004522:Educational Status; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D034742:Electronic Mail / Q000706:statistics & numerical data*; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D007407:Interviews as Topic / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D010820:Physicians / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015995:Prevalence; D017678:Sex Distribution; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000453:epidemiology / Q000473:pathology*; D014481:United States