Should patients have direct access to their lab results?

As part of their push towards more transparency of health care records, the Obama Administration is now allowing patients in all states to access their lab results without having to ask their doctors for permission.

“The right to access personal health information is a cornerstone of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule,” Health and Human Services secretary Kathleen Sebelius said in a press release on Feb. 3. “Information like lab results can empower patients to track their health progress, make decisions with their health care professionals, and adhere to important treatment plans.

While some states already allowed patients to have access to their records without a doctor, 13 states barred laboratories from giving the information directly to patients, and 7 states allowed it only with the doctor's permission, the Wall Street Journal reports. 

"A number of patients are getting increasingly active in managing their own health care, and having a gatekeeper between them and their data is just baffling," said Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology, told the Journal.

An Archives of Internal Medicine study showed that doctors forgot to notify patients about their abnormal test results about 7 percent of that time.

McGraw added that he thinks doctor’s offices just get so busy that they sometimes forget to tell patients, and patients may go about their day thinking that everything is fine.

But some doctors and medical groups -- including the American Medical Association and the American Academy of Family Physicians -- warn that the move could create more problems. Patients don’t have the knowledge to correctly interpret their results, and they may go online to self-diagnose themselves with health issues they don’t have. Even worse, they may try to self-medicate based on what they learn.

“I think there’s a risk with patients seeing the results without having the perspective of how to interpret them,” Dr. Jon LaPook, CBS News chief medical correspondent, said.

LaPook gave the example of a patient who had barely elevated creatinine levels, but because it was outside the normal range, it showed up as an abnormal result on her test. When she saw the data late at night, she began to panic.

She got a hold of LaPook early the next morning, notifying him she had already began to look for options for a kidney transplant. LaPook let her know she was completely fine.

“She was a nervous wreck!” he recalled.

LaPook said that because there are so many different blood tests these days, it's likely that a patient may encounter at least one abnormality. 

He also pointed out that "high" results aren’t necessarily bad: high “good” HDL cholesterol numbers or b12 levels are applauded.

LaPook said he always reviews lab results with his patients, and also provides them with a copy to take home. The important part is they have the context to understand what all the numbers mean.

“In the best of all worlds, the labs are drawn before the doctor’s routine visit, and ready so by the time the patient comes to the office, he can sit down with the doctor and review the results,” he said.


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