Systematic Design of Meaningful Presentations of Medical Test Data for Patients

Advances in patient-centered care and health information technology (IT) mean that most patients have access to laboratory tests. These data should enable patients to be active participants in their healthcare decisions and to potentially manage their health behaviors. However, it cannot be assumed that providing patients, particularly those with lower numeracy skills, with their test results or risk estimates will lead to an understanding of those numbers. Results are commonly presented in formats that may be difficult for patients to interpret, causing confusion.

This project evaluated how to best present laboratory results to patients in a more understandable and useful manner. Researchers tested generalizable principles of data presentation and simultaneously evaluated the specific clinical context of diabetes and hemoglobin A1c results. By making results more intuitive and meaningful to patients, investigators aimed to promote communications that could improve patient self-management of chronic conditions and participation in medical decision making.

The specific aims of the project were as follows:

• Conduct an intensive "deep dive" brainstorming session to identify patient needs, barriers to patient data use, and potential solutions for development and testing. 
• Conduct comparative evaluations of proposed designs. 
• Incorporate identified test results communication best practices into an online test results "display generator" application. 

Researchers held a multidisciplinary brainstorming session and used research methodologies from design science, decision psychology, human-computer interaction, and health communication to develop a comprehensive research process and create a visual format for test-result displays. They conducted iterative usability testing with patients and engaged healthcare providers for input. Researchers developed and tested multiple designs that used visual features such as distinct color-coded categories, color gradients, harm threshold points, visually displayed target ranges, and historical data points; they also conducted comparative evaluations of the designs in seven large-sample survey experiments.

Study findings indicated that visual displays informed by patient input can improve understanding of test results and increase patient sensitivity to results outside of the standard reference range. They found that the tabular format currently used in patient portals is not the optimal approach to displaying results to patients. However, they found that the data can be made more intuitive through visual design and inclusion of relevant contextual cues, such as disease-specific goal ranges. Researchers hypothesize that translating this design work into improved patient understanding is feasible, although it will require buy-in from developers to incorporate these approaches into their systems.