New rule proposes to put pathology results directly into hands of American patients

news item on patients' pathology results being available to them

A new rule proposed by the U.S. Department of Heath and Human Services (HHS) may soon give American patients direct access to their laboratory results.

The proposal was announced at the first HHS Consumer Health Information Technology (IT) Summit on September 12. Allowing patients to obtain their test results directly from the laboratory is part of a larger movement towards expanding the use of health information technology. The reforms are intended to empower patients, coordinate better care, and improve health care quality.

Under the proposed rule, all patients or their representatives will be able to directly access their pathology tests after having their identities verified, regardless of state restrictions. Currently, many states require patients to go through their health care provider to receive their test results or for permission to receive them from laboratories, as do current federal regulations.

The proposed rule is open for comment for 60 days after its publication in the Federal Register. A final rule is due to be published later this year, after consideration of comments received.

The rule is intended to allow patients to take a more active role in their health care decisions. According to a 2009 study from the Archives of Internal Medicine, up to 7% of abnormal test results are not shared with patients. HHS believes that test result access will enable patients to monitor their own results and ask the right questions of their doctors, and will provide greater assurance that an abnormal result is not overlooked. The rule encourages patients to act as partners with their health care providers, rather than remain passive health care consumers. Studies have shown that greater availability and understanding of personal medical information such as pathology results can encourage patients to follow treatment protocols and make the healthy choices recommended by their doctors.

More ready access to test results, however, places patients in a position of greater responsibility. Patients may encounter complex test results and they will need to recognise that there is a context in which providers use results to make treatment decisions. This may require that patients educate themselves about their tests in order to understand why certain tests were ordered and the references intervals used in laboratory results. (See the article Reference ranges and what they mean) The availability of Lab Tests Online and other credible health information online can assist those looking for a better understanding of their medical information. Patients should still look to their doctors as the ultimate informed partner for understanding test results and providing treatment options.

The new HHS rule is part of a general drive towards using health information technology to improve patient care. Electronic health care databases will simplify information transfer between patients and their primary care doctors and specialists, improving coordinated care and reducing redundancies in medical tests and procedures. Providing pathology tests directly to patients is one step in the cycle of information access, enhancing doctor and patient dialogue to improve medical care.

In Australia patients are entitled to receive a copy of their results and many doctors do provide hard copies of results to their patients at the consultation. It would be very unusual in Australia for patients to be able to access their results without going through their doctor. Currently there are no plans in Australia for this kind of direct on-line access to their laboratory results but as the e-health agenda is progressively rolled out in Australia, it is quite possible that consumers may demand this kind of access in the future.

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