Comments on: Do patients really need their complete lab and radiology reports? http://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: johannahttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110593 johanna Thu, 27 Aug 2009 15:50:34 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110593 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. 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.

]]> By: Outriderhttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110443 Outrider Tue, 25 Aug 2009 21:15:00 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110443 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). 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).

]]> By: MillCreekhttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110412 MillCreek Tue, 25 Aug 2009 17:02:33 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110412 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. 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.

]]> By: MillCreekhttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110397 MillCreek Tue, 25 Aug 2009 15:04:20 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110397 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. 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.

]]> By: Headline Commentary Aug 18-Aug23 | Health Content Advisorshttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110376 Headline Commentary Aug 18-Aug23 | Health Content Advisors Tue, 25 Aug 2009 12:33:18 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110376 [...] » Do patients really need their complete lab and radiology reports? | KevinMD.com [...] [...] » Do patients really need their complete lab and radiology reports? | KevinMD.com [...]

]]> By: Whttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110180 W Sat, 22 Aug 2009 19:36:52 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110180 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. 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.

]]> By: C. Scot Gileshttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110174 C. Scot Giles Sat, 22 Aug 2009 18:47:07 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110174 I tell all of my clients to get copies of all of their labs and scans. You would be amazed how often charts get lost. I've seen dozens of cases where a chart went missing between hospitals and that patient's personal notebook of scans and tests became a life-saving tool. I tell all of my clients to get copies of all of their labs and scans. You would be amazed how often charts get lost. I've seen dozens of cases where a chart went missing between hospitals and that patient's personal notebook of scans and tests became a life-saving tool.

]]> By: Nuclear Firehttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110176 Nuclear Fire Sat, 22 Aug 2009 18:02:21 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110176 I really appreciate patients like YATYTHAHA. Makes my job easier and their care better. I really appreciate patients like YATYTHAHA. Makes my job easier and their care better.

]]> By: You are too young to have a heart attack...http://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110171 You are too young to have a heart attack... Sat, 22 Aug 2009 16:07:01 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110171 I get copies of all my reports for three reasons. 1. I have a rare disease most doctors would not know enough about (if they knew of it) to diagnose it in a patient. 2. Because I was misdiagnosed (see #1 above), I had a stroke which has compromised my memory, so all the discussions in the world with my doctor do not follow me home intact, and having the info to read helps bring that back. 3. If I have an event and need to go to the ER, I can provide them with the most recent consult letter and reports so they can take care of me and order the appropriate tests, as most doctors don't seem to take the word of the patient.Seems like a win-win to me! Being a doctor is hard work, being a patient who is not listened to when they know something is terribly wrong, even harder and the fall out is for life... I get copies of all my reports for three reasons.

1. I have a rare disease most doctors would not know enough about (if they knew of it) to diagnose it in a patient. 2. Because I was misdiagnosed (see #1 above), I had a stroke which has compromised my memory, so all the discussions in the world with my doctor do not follow me home intact, and having the info to read helps bring that back.
3. If I have an event and need to go to the ER, I can provide them with the most recent consult letter and reports so they can take care of me and order the appropriate tests, as most doctors don’t seem to take the word of the patient.

Seems like a win-win to me! Being a doctor is hard work, being a patient who is not listened to when they know something is terribly wrong, even harder and the fall out is for life…

]]> By: Nuclear Firehttp://www.kevinmd.com/blog/2009/08/do-patients-really-need-their-complete-lab-and-radiology-reports.html#comment-110160 Nuclear Fire Sat, 22 Aug 2009 14:36:57 +0000 http://www.kevinmd.com/blog/?p=39618#comment-110160 You didn't read carefully enough. My patients DO get all their labs. I want to provide an extra service to those that would want it but our lawyer (a young progressive guy who thought it was a great idea for both patient satisfaction and financially) when asked if this was Kosher with HIPPA (not if it was opening us up to risk) said they read it as a violation while post mail or fax is not. I may think it's ridiculous but obeying federal law isn't CYA. If you don't like it, please get your representatives to write better laws; I'm sick of being hamstringed by silly laws. You didn’t read carefully enough. My patients DO get all their labs. I want to provide an extra service to those that would want it but our lawyer (a young progressive guy who thought it was a great idea for both patient satisfaction and financially) when asked if this was Kosher with HIPPA (not if it was opening us up to risk) said they read it as a violation while post mail or fax is not. I may think it’s ridiculous but obeying federal law isn’t CYA. If you don’t like it, please get your representatives to write better laws; I’m sick of being hamstringed by silly laws.

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