Attached an article published in today's Miami Herald reporting that Quest Diagnostics, the nation's largest provider of lab services, is allowing patients to get test results sent to them directly but is NOT permitted doing so in Florida! Why? Florida state statute 483.181 requires that lab results "must be reported directly to the licensed practitioner or other authorized person who requested.'' An administrative code interpretation states: "No report . . . shall be sent to the patient concerned except with the written consent of the authorized person who requested the test.''
In my opinion this need to change! Medicine should be a collaborative effort between physicians and patients. Accountability and transparency should be the focus of our medical care. In my practice each and every patient has the right to receive his/her diagnostic test results within 48 hours via e-mail or mail with attached interpretation of the results. This excludes results that requires a one-on-one discussion (positive HIV, significant MMG and Biopsy results etc.) One way to circumvent this issue is the establishment of personal health records and patient portals. I transfer all of my Allscript Prescription data to the patients personal health record if so requested. Many do not know that this even exists.
Looking forward to your feedback.
yours
Bernd
The Miami Herald
Posted on Fri, Jan. 21, 2011
Get lab results quickly, but not here
BY JOHN DORSCHNER
jdorschner@MiamiHerald.com
With healthcare experts pushing for more patient involvement, Quest Diagnostics, the nation's largest provider of lab services, is allowing patients to get test results sent to them directly -- but not in Florida.
``Disclosure and transparency is here and now,'' said Jon Cohen, Quest's chief medical officer, at a recent University of Miami symposium.
Well, not exactly here. Florida is one of 13 states that forbids diagnostic companies from transmitting results directly to patients.
That makes no sense to Beth Wheeling, a retired South Miami psychologist and cancer patient. ``Why is there this infantilization of the patient? Why do they think we cannot handle this? I hope Florida grows up.''
The Florida Medical Association and the American Medical Association did not respond to requests for comment.
The Quest initiative ``is the beginning of a trend toward more knowledge for consumers,'' said Russell Robbins, a doctor and principal at Mercer, a national consulting firm.
He said it has previously been possible for patients using some smaller labs to go to the Web for results, but with this new program ``the information is getting back freely'' by automatically being sent to smart phones via a special app.
LabCorp, the other big national testing company, did not respond to four requests for comment.
The Quest program, called Gazelle, is presently set up only for smart phones and includes ways for people to access and keep track of their medical records. Patients who sign up for the service have to wait 48 hours after the doctors get the results, so the physician can first have a chance to talk to patients.
Quest research shows that 7 percent of negative test results never reach patients because of communications mix-ups, Cohen said. In another 14 or 15 percent of cases, tests are duplicated by other doctors because they don't have access to the original results. That can be remedied by a patient having test results on a phone and being able to forward them quickly to whomever he or she wants.
One exception for Gazelle: It will not be used to transmit seriously bad news, such as testing positive for cancer or the HIV virus. ``That's best told by a professional,'' Cohen said.
Quest surveys show that patients who see test results -- cholesterol and blood sugar levels -- are more likely to be motivated to take better care of themselves.
That makes sense to Bernd Wollschlaeger, a North Miami Beach family physician and former president of the Dade Medical Association. ``I don't see any downside'' to the Quest program.
``We should be establishing collaborative care'' in which doctor and patient work together.
However, state statute 483.181 requires that lab results ``must be reported directly to the licensed practitioner or other authorized person who requested.''
An administrative code interpretation states: ``No report . . . shall be sent to the patient concerned except with the written consent of the authorized person who requested the test.''
A Quest spokesman said the company has software that allows doctors to forward Quest results to patients, which Florida doctors could use if they want.
Robbins, the Mercer consultant, said it's important that patients get the information to go along with the tests -- for example, what a number for platelets really means. ``Hopefully these results will be in conjunction with discussions with doctors.''
Robbins said a blood test ``is really a snapshot of when the blood was drawn,'' and it's often important that a result be compared with other results, which ideally would be kept in an electronic personal health record.
Wheeling, the retired psychologist, said she would love to see faster reporting on all sorts of tests because of the anxiety in waiting for results. She recalled going to the hospital for a scan to see if cancer had returned. The test showed it had not, but it took her a week to learn that.
``I think somebody at the hospital looked at the scan and could have told me within minutes,'' Wheeling said. ``The wait is totally unacceptable.''
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4 comments:
I've been trying to get my lab report for a skinn culture done on 3/17/2011.The doctor's office manager claimed she didn't have it in April. I handed her a signed HIPPA request formon April 4, sent 3 more letters in 2011 requesting my lab report to the doctor, with a SASE, complained to Medicare, and still NO LAB REPORT. Oh and I did request my labs from Quest too, which they refused. More about this here: http://rabblewriter.blogspot.com
My Florida doctor will not authorize Quest to send me the lab results. They believe that it's a HIPAA violation for have lab results mailed at all.
This is a ridiculous law it seems to be written by doctors that want to ensure revenue stream thru repeat visits. As a patient I see routine blood work as a vital tool to help me monitor lifestyle changes that affect my cholesterol and thyroid levels. I find that doctors are usually unwilling to give this information freely as they want to control repeat visits. Myself as the patient of over 13 years of living daily with a thyroid issue can better monitor life style than can a doctor that sees me once a year as one of a thousand patients. The medical field needs to be more transparent in all aspects. I feel if a patient can have more access to records and cost of procedures the will do a better job of monitoring themselves and be able to keep cost down. Most patients have no clue what their doctors and labs are charging if they could see all information as to cost and results that would be a good thing for all.
The core of LabWrite is the lab report, helping you write your lab report step-by-step. ..... Why does PostLab ask me to write my report starting with Methods?do my lab report
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