JAMA: Proposed patient-access policy requires research
Although a proposed policy that would provide patients with the right to request and receive their test results directly from laboratories could empower them and reduce physicians’ workloads, it’s unclear what the specific effects of such a policy would be, according to Hardeep Singh, MD, Baylor College of Medicine in Houston, in a recently published Journal of the American Medical Association commentary.
“Although the rule could be considered a monumental step forward to improve the safety of test-result follow-up, there is a lack of consensus in the literature about best practices in direct patient notification of abnormal results,” Singh wrote.
The Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC) and the Office for Civil Rights (OCR) jointly proposed amending the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and HIPAA in order to allow for more immediate patient access to test results in September, arguing that the proposed policy would reduce the amount, currently between 8 and 26 percent, of abnormal test results that aren’t followed up in a timely manner.
Singh suggested that possible benefits from the proposed policy could be limited because:
Singh added that more research regarding patient access to test results should be conducted before a policy allowing access is pursued.
“Although direct patient notification of certain test results has been implemented in a small number of U.S. health systems, there is limited evidence that it leads to better follow-up," Singh concluded. "How potentially immediate direct access to laboratory results will affect the workload and workflow of the currently overwhelmed health system and physicians is even less clear."
“Although the rule could be considered a monumental step forward to improve the safety of test-result follow-up, there is a lack of consensus in the literature about best practices in direct patient notification of abnormal results,” Singh wrote.
The Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC) and the Office for Civil Rights (OCR) jointly proposed amending the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and HIPAA in order to allow for more immediate patient access to test results in September, arguing that the proposed policy would reduce the amount, currently between 8 and 26 percent, of abnormal test results that aren’t followed up in a timely manner.
Singh suggested that possible benefits from the proposed policy could be limited because:
- There are no processes for releasing test results directly to patients;
- Patients don’t possess the know-how to interpret medical data; and
- Patients may be less inclined to accept physician advice.
Singh added that more research regarding patient access to test results should be conducted before a policy allowing access is pursued.
“Although direct patient notification of certain test results has been implemented in a small number of U.S. health systems, there is limited evidence that it leads to better follow-up," Singh concluded. "How potentially immediate direct access to laboratory results will affect the workload and workflow of the currently overwhelmed health system and physicians is even less clear."