Primary Care Providers’ Preferences and Concerns Regarding Specific Visual Displays for Returning Hemoglobin A1c Test Results to Patients

Brian J. Zikmund-Fisher, Jacob B. Solomon, Aaron M. Scherer, Nicole L. Exe, Beth A. Tarini, Angela Fagerlin and Holly O. Witteman
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Brian J. Zikmund-Fisher: Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
Jacob B. Solomon: athenahealth, Watertown, MA, USA
Aaron M. Scherer: Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
Nicole L. Exe: Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI, USA
Beth A. Tarini: Center for Translational Science, Children’s National Medical Center, Washington, District of Columbia, USA
Angela Fagerlin: Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
Holly O. Witteman: Department of Family and Emergency Medicine, Laval University, Quebec City, QC, Canada

Medical Decision Making, 2019, vol. 39, issue 7, 796-804

Abstract: Purpose . Patient portals of electronic health record systems currently present patients with tables of laboratory test results, but visual displays can increase patient understanding and sensitivity to result variations. We sought to assess physician preferences and concerns about visual display designs as potential motivators or barriers to their implementation. Methods . In an online survey, 327 primary care physicians (>50% patient care time) recruited through the online e-community/survey research firm SERMO compared hemoglobin A1c (HbA1c) test results presented in table format to various visual displays (number line formats) previously tested in public samples. Half of participants also compared additional visual formats displaying target goal ranges. Outcome measures included preferred display format and whether any displays were unacceptable, would change physician workload, or would induce liability concerns. Results . Most (85%–89%) respondents preferred visual displays over tables for result communications both to patients tested for diagnosis purposes and to diagnosed patients, with a design with color-coded categories most preferred. However, for each format (including tables), 11% to 23% rated them as unacceptable. Most respondents also preferred adding goal range information (in addition to standard ranges) for diagnosed patients. While most physicians anticipated no workload changes, 19% to 32% anticipated increased physician workload while 9% to 28% anticipated decreased workload. Between 32% and 40% had at least some liability concerns. Conclusions . Most primary care physicians prefer visual displays of HbA1c test results over table formats when communicating results to patients. However, workload and liability concerns from a minority of physicians represent a barrier for adoption of such designs in clinical settings.

Keywords: computer graphics; clinical laboratory information systems; decision making; education of patients; electronic health record (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:7:p:796-804

DOI: 10.1177/0272989X19873625

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