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Can patients use test results effectively if they have direct access?

BMJ 2015; 350 doi: (Published 11 February 2015) Cite this as: BMJ 2015;350:h673
  1. Maurice O’Kane, consultant chemical pathologist, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, UK,
  2. Danielle Freedman, director of pathology, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK,
  3. Brian J Zikmund-Fisher, associate professor, Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
  1. Correspondence to: M O’Kane Maurice.OKane{at}, B J Zikmund-Fisher bzikmund{at}

Maurice O’Kane and Danielle Freedman say that patients welcome direct access to test results and that they improve clinic visits, but Brian J Zikmund-Fisher worries that the data are currently presented in ways that make them meaningless to most patients

Yes—Maurice O’Kane and Danielle Freedman

Patients increasingly have direct access to medical records and test results. This increased patient engagement may contribute to better decision making and care. Evidence indicates that patients value access to test results, particularly those with chronic disease. Having direct access may improve the doctor-patient relationship and increase satisfaction with care. Traditionally, patients access test results through the requesting clinician, who provides an interpretation and puts the results in the context of the patient’s overall health condition. This model presents problems, however, in particular delays in communicating results to patients. Evidence from several studies has highlighted failure to inform patients of abnormal results in a substantial proportion of cases and also clinicians overlooking results that should have been acted on.1 2

In February 2014 the US Department of Health and Human Services, partly in response to concerns that patients were not receiving test results (and some high profile cases in which cancer diagnosis reports were overlooked by the clinical team), mandated patients’ direct access to reports of their laboratory tests. NHS England has also stated that patients should have direct access to medical records held by general practitioners, including test results.

Patients welcome access to test results and think that it provides better preparation for clinic visits and more efficient consultations.1 3 4 Although access to results occurs within the wider context of empowering patients through direct access to medical records, concern has been raised that an unwelcome result or misinterpretation of the findings could cause patients anxiety. This in turn might increase clinicians’ workload by raising demand for …

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