Most prefer the bottom line, sparing them the raw data.
Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.
So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):
Much of the data is not relevant, with the abnormal results in the range of lab error. Many patients won’t know what to do with these numbers, although I can appreciate the few who are diligent and enter such values in a spreadsheet so they can track it.
So, when you consider that the amount of time a primary care doctor is able to spend with patients is shrinking, does it really need to be filled up by questions generated from essentially normal lab reports?
Alas, as you can see from the comments generated by Dr. Rob’s post, there’s no clear-cut answer, as some prefer to receive the raw data, while others simply want the bottom line.
If there was an efficient way for patients to make their preferences known, that probably would be the best solution. However, considering I review hundreds of lab tests daily, there’s no way I can keep track of how much detail an individual patient would want in their lab reports.
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NF: I read your earlier post closely enough to understand that you were getting complete information to your patients despite being unable to use e-mail, and I considered your patients lucky to have you. I did not understand that your lawyer also would have supported the practice — also commendable. Perhaps he can still find a way around his resources’ interpretation of HIPAA. No, I do not appreciate government interference in the doctor-patient relationship, any more than I appreciate the meddling of attorneys less wise and compassionate than yours. Have a good day.
Chiming in again as the risk manager: there are indeed legitimate HIPAA concerns that can arise from emailing PHI to patients. Most practices do not have the electronic security measures in place to allow this to be done in accordance with the regulations. There has as yet been little case law interpreting the regulations so most people are being very cautious about potentially running afoul of the electronic security requirements.
I personally am a fan of using a secured website to allow patients to look up their labs. This is an approach that has generally passed muster. I usually only see this in the larger clinics or health systems that have the necessary IT people on staff to implement the security measures.
Interesting story on MSNBC today on the issue of tests falling through the cracks: http://www.msnbc.msn.com/id/32490265/ns/health-health_care/
I am going to have to read the Archives article as well. Neither the findings nor the recommendations in the MSNBC article are new to me.
I’m a DVM and I have absolutely no problem reading my own laboratory and radiology reports. I vastly prefer reading raw data myself to discussing findings with the average MD, which is generally redundant and frequently useless. Sure, there are a few species differences, but in my experience, I haven’t needed to ask an MD to look up any “big words” for me. Actually, because I’m accustomed to taking species differences into account when interpreting test results, I’m better equipped to read my own test results than the average MD is to read his or her animal’s test results (yes, I am dead serious).
I find this entire issue to be ridiculous. If my clients want their test results, I hand over a copy; if a client has questions, I answer the questions. It takes 5-10 minutes but I want the client to understand… after all, s/he paid for the tests (already).
It is policy that we always set a follow up appointment when scheduling labs. The labs are always explained in detail and the patient is given an update on their progress from previous lab, then they are given a copy to take home. At the time of lab follow up all other chronic disease and medication is reviewed and adjusted accordingly. This not only tends for great patient satisfactionand better compliance, but is what primary care should be about, the patient centered medical home. It takes less time taken from staff and physician explaining over phone for free. (Ma’am your lab is normal,….”but what was my cholesterol last time I got labs?”….etc.) Most of the time we get a level 4 billing from those visits because of the comprehensive follow up and education on all of the different issues covered and can usually do all of this within 20min. We always do this at time of annual physicals as well, with their chronic issues as carve outs.
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