A patient has seen their test result before the doctor called. How should you talk to them?

A result flagged in red is not a ready-made diagnosis

A patient opens the app in the evening and sees a value flagged in red. Next to it is a report with a difficult medical term. Before contacting the doctor, he looks up what the words mean, reads about worst-case scenarios and rings reception: “I’ve got a serious illness and nobody warned me.” His anxiety is understandable. The app shows that the result falls outside a set range, but does not explain how that relates to his symptoms, age, other results and treatment history. The doctor should not simply reply: “Please don’t panic, it’s only a number.” It is better to ask: “What did you see, and which part worried you most?” Then the content of the result can be separated from the patient’s interpretation of it. An abnormality should not automatically be played down, because some results require prompt assessment. The point is for the conversation to help the patient understand what the result means for their health.

What research says about immediate access to results

In a US study by Steitz and colleagues published in 2023, 8,139 patients and care partners using the portals of four academic medical centres responded. Among those who answered the question about preferences, around 96% wanted to receive their results immediately, even before speaking to a doctor. Some respondents, particularly those with abnormal results, reported increased worry. This is not the result of a representative study of Polish patients using the Internet Patient Account (IKP). Participants chose to take part themselves, and the response rate to invitations was limited. The conclusion should therefore be framed more cautiously: many portal users value quick access, but the document alone is not enough for everyone. That is why the solution does not have to be delaying the release of results. It may be more helpful to prepare the patient for what they will see and to point out where they can ask questions. Access to data increases autonomy only when the patient understands what they can do with it.

Who should explain the result to the patient, and when

When ordering a test, you can give a simple piece of information: “Your result may appear in the system before we speak. Some values are flagged automatically. We’ll assess them together with your other information and get in touch at the time we’ve agreed.” Such a commitment must, however, reflect what the facility can actually deliver. You cannot promise a phone call within 24 hours if nobody has been given responsibility for reviewing documents. In Poland, the range of data visible in the IKP and other apps depends on the type of records and how providers make them available. The fact that a patient can see something does not mean that every lab result automatically appears in one place at the same time. The organisation should make clear who assesses the result, who communicates the information and how the patient can raise a concern. Where sensitive data is involved, information protection and verification of the identity of the person asking also apply.

The first conversation: from worry to shared understanding

When a patient says “I’ve got cancer, because that’s what the report says”, it is not enough to deny it. The doctor might begin: “I can see you’ve read the report as a diagnosis. Let’s look together at what exactly was found and what still needs to be clarified.” Then explain the significance of the result in its clinical context and the limitations of the method used. It helps to break this down into three levels: the observation in the test, the possible interpretations and what will make it possible to decide between them. It is also important to name uncertainty without over-reassuring. “There’s nothing to worry about” is not the right answer if the assessment is still ongoing. Better: “At this stage we have no grounds to settle on a diagnosis. We need to check certain information.” For some people, the conversation should take place urgently, depending on the clinical assessment of the result. In every situation, it is worth asking what question the patient wants to ask first.

Reception is not there to interpret results

Some of the anxiety reaches the people answering the phones first. A receptionist may hear: “Please tell me whether this result is dangerous.” They should not step into the doctor’s role or read data aloud to someone whose identity has not been confirmed. What they do need are specific instructions: where to direct the query, how to recognise a situation that needs to be passed to clinical staff immediately and how to log the contact. An example reply might be: “I understand the result is worrying you. I can’t assess what it means medically, but I’ll pass the information on to the appropriate person in line with our procedure.” The organisation must ensure this process runs continuously, including during holidays and shift changes. It is also good practice to record whether the patient received a reply. Otherwise, the query can get stuck in a queue that nobody is responsible for, and the patient is left with a document and growing anxiety.

By the end, the patient should know who will do what, and when

At the end of the conversation, it is worth answering three questions: what we know, what the next step will be and who is responsible for getting in touch. “The result needs to be compared with your previous test. We’ll arrange a specific assessment, and the person responsible will contact you on the agreed date.” The actual plan must follow from the clinical assessment. While you are at it, it is worth saying which symptoms or situations change the urgency and how to get help in line with the facility’s rules. Then ask: “Just to make sure I’ve explained the plan properly, what will you do after today’s conversation?” Checking understanding in this way does not shift the blame onto the patient. If someone is still anxious, it does not automatically mean the doctor explained things badly; the emotions may stem from genuine uncertainty. Clear arrangements, however, make it possible to distinguish a need for more information from a dangerous delay.

Patients have a right to information, and quick access to their records may be important to them. A result in an app, however, is no substitute for a clear conversation and appropriate medical care. A good process starts when the test is ordered, provides a clear pathway for urgent results and ends when the patient understands what is known about their result and who will contact them again.

How Em helps you prepare a clear conversation about a worrying result

The manager of an outpatient clinic describes a recurring situation to Em: a patient sees a red result in the app, rings in a state of distress and expects a diagnosis from reception. She does not share any personal data or the specific result. She asks for help in preparing two conversations. The first is for a receptionist and should show empathy while handing the query on safely. The second is for a doctor and should begin with a question about the patient’s concerns and end with a clear plan. Em helps her distinguish empty reassurances from a factual explanation and test the wording under time pressure. The manager can also practise a conversation with the team about who takes over a case and how they confirm that contact has been made. After consulting those responsible for procedures, the clinic develops more consistent language. Empatyzer does not retrieve results from the IKP or interpret them. It helps the team prepare for a conversation that gives the patient a clear explanation and tells them who to turn to.