Today’s Managing Health Care Cost Indicator is 13
Thirteen states currently have laws on the books that prohibit laboratories from releasing results directly to patients, and insist that all laboratory results are “sent only to the physician or authorized health entity.”
The AMA is opposing new proposed federal regulations that will mandate that laboratories disclose results directly to patients – which will allow downloading of data to personal health records that are not associated with the patient’s physician. Hence, the red states on this map are those where lab results can be “sent to the patient without physician approval.”
I believe that patient engagement can improve the quality of care, as well as ultimately lower the cost. Patients should see their laboratory results, and they should feel comfortable asking questions if they don’t understand them. In my own clinical practice, patients seeing their own test results occasionally asked a question that helped me avoid making an error. They often asked me a question that let me address their real underlying concern.
Some physicians are worried that patients will ask questions about all sorts of irrelevant tiny abnormalities – leading to a clogged switchboard, wasted time, and unnecessary follow-up tests. However, when we gave our patients access to their laboratory data at Harvard Vanguard through a secure portal – we heard absolutely no complaints about this.
Malpractice suits for “delay in diagnosis” for breast cancer with abnormal mammogram declined substantially after a federal regulation required that radiologists communicate the results of mammography directly to the patient. (Note I have not successfully found a good reference for this – but this was reported by CRICO, the Harvard medical malpractice carrier).
I think the AMA is doing us a favor by providing this map. It’s time to empower patients and give them access to their own information, which will help improve the quality of care. Let’s just be certain to get the ‘red states’ and the ‘green states’ right. The green states should be those that insist that as a patient you have the right to receive your own laboratory data!
