Useless Access to Patient Data

Patient access to their own health care data has snagged center stage for some time. Now there is a movement to make lab tests directly available to patients.

Sure, patients like to get phone calls from their practitioner’s nurse about the results of their lab tests, even if those tests are normal. In our area, if the practitioner tells lab patients they will get a call only if the results are abnormal, the patients will call the office and ask for the results anyway.

If the practitioner tells lab patients they will receive a letter that the results are normal, they will still call the office for the results.

I have no problem with lab results being directly available to patients. The real issue here is whether it makes any substantial improvement in a patient’s care. Because the patients in our area call for lab results no matter what they have been told, there is little chance of an abnormal lab result moldering about for any length of time, thereby allowing some bad lab result to cause harm at some later date.

In our rural practice, the local hospital has for years offered a panel of standard tests to area residents for a flat fee. Patients go to “wellness days” for testing, the results are faxed to our office or patients make an appointment and bring the test results to our clinic for review with a practitioner. We know the tests would likely be paid for were they part of a physical examination or the patient had a condition which indicated a given lab test were needed, but our patients continue to go to the hospital for their tests and pay for them out of their own pockets. The hospital is happy.  These lab tests are a cash cow for the hospital.  Not a lot different than patients in many areas who pay a substantial fee for itinerant caratid untrasounds, ultrasounds which any physician would have to repeat if the patients brought abnormal itinerant results to the office.

So, right in sync with the notion that patients should have immediate access to their lab test results, “wellness days” puts such results right in the hands of the patients. Notice that most patients still go to their practitioners for a review of the tests—even when they are normal.

Sure, patients can find a lot of information about their labs on the internet. However, patients often don’t realize that even if they can find the “normal” range for lab tests on the internet, that doesn’t mean the “high” or “low” on their own tests requires that anything be done. Practitioners know which lab results glaringly marked with a raucous “H” (high) require immediate attention and which results one-tenth out of normal range need only “mindful” watching.

Practitioners also know which lab tests are more important than others. The usefulness of common lab tests can be a hot topic of debate among professional organizations. For example, see the National Academy of Hypothyroidism on the usefulness of the TSH test.

So once again, we have impending government regulation which forces laboratories and practitioners to come up with some kind of computer software to make patient lab tests directly available for patient review. And you can guess who pays for this. Far cheaper to have local “wellness days.”

The people like the writer of this article think patients access to lab tests is a great idea. Everyone should have access to their personal health data.  But does having access to lab results on the lab site really help patients in any substantial way?

Nada.

The patient will likely make an appointment to review the labs with the practitioner anyway, because after all, those labs are part of a big picture which should probably include a practitioner overview.

THAT is the perspective regulation mongers can’t comprehend.

dhaugen
Some young HR person once looked at my CV and asked me, quite seriously, if I had really done everything I had listed there. Well, yes. Because I am someone who can't sit in a Morris Miller cubicle every day, much less for any great stretch of time. Once the problem is solved, I get bored and I'm ready to move on to the next challenge. This hasn't afforded me any great stability in my work life. I simply arrive in places about ten years ahead of time. So far, at least, that penchant for early arrival hasn't been accompanied with a pocketbook full of door knobs.
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