Direct patient access to lab results causes physician stir

As FierceHealthIT reported this week, the Department of Health & Human Services (HHS) wants to change current rules to give patients direct electronic access to their lab results.

HHS Secretary Kathleen Sebelius and other proponents of amending patient privacy provisions of the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) say the move will help empower patients and encourage them to take more control of their health.

But not all physicians are eager to give up their role in conveying test results to patients, primarily out of concern that patients may misinterpret the data. "Lab results often contain a lot of information. A patient downloading many raw lab results from the Internet may be overwhelmed by lots of tiny, insignificant abnormalities that could each demand an individual explanation--and cause significant worry until those concerns are dealt with," Dr. J. Fred Ralston, former president of the American College of Physicians and a practicing internist at Fayetteville Medical Associates (Tenn.), told InformationWeek Healthcare. "We also need to understand that no table or explanation can fully describe different ranges of normal. In some cases what a patient might think is a normal reading for them may not be the case," Ralston added.

However, executives at Quest Diagnostics, which already has nearly 100,000 patients using its 11-month old app, Gazelle, to access test results via their smartphones, say that the 48-hour lag time between when physicians get results and their patients does give doctors enough time to share and discuss the results personally first.

Jon R. Cohen, chief medical officer at Quest, also noted to the Wall Street Journal the frequency that test results fall through the cracks in busy medical practices, particularly those that employ a "no-news-is-good-news" policy for delivering test results. He cited a 2009 study of medical practices that showed practices failed to follow up on test results or document that they had done so up to 26 percent of the time, with an average of 7.1 percent.

To learn more:
- read the press release from HHS
- read the Notice of Proposed Rulemaking (.pdf)
- read the article from the Wall Street Journal
- read the article from InformationWeek Healthcare

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