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You Have a Right to Your Lab Results: New Rules Provide Direct Access

By Marcia Mangum Cronin

Created: 02/19/2014
Last Updated: 02/19/2014

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The Obama administration recently announced new regulations that allow patients to get laboratory test results without going through their doctors first. These rules, effective Feb. 3, are part of an effort to give patients more control over their health care. They supersede state laws that forbid labs from releasing test results directly to patients.

In some states, patients already had the right to direct access to lab results, while other states required a doctor's permission and some wouldn't allow it at all.

Now, all adult patients can directly get their own lab results and will share responsibility for discussing them with their health care professionals (HCPs).

Some doctors and physician organizations had raised concerns that patients would be unable to interpret lab results without help from HCPs. They feared that a patient might act on a report showing abnormal results, when actually those results could be normal for that particular patient—or could be a false negative or false positive that might require additional testing or analysis.

It would be great if our health care providers always called immediately to discuss our lab results, but sometimes they don't. One study found that 1 out of 14 patients with negative results never received that information from their doctors.

And some health care providers only call patients to report negative results, or they may call and tell you you're in the normal range but don't tell you your exact numbers. If a blood marker is within the range of normal, but is only one point away from a danger zone, I personally like to know so that I can take preventive action, if possible. On the other hand, if I'm solidly within the normal range, I don't need to worry about it. If your HCP calls to tell you your results, be sure and find out your precise numbers.

Interpreting lab results can be difficult. The key thing to know is that if something shows up out of the range of normal, you should your HCP and ask about it—if your HCP doesn't you first.

A recent blood work lab report I received listed over four dozen measurements. Thankfully, almost all were within the normal range. For the four that were slightly outside of the normal range, there was a “Comment” section at the end giving a bit of additional information. It noted that one score has not yet been cleared by the U.S. Food and Drug Administration, meaning that “the clinical utility of these tests has not been fully established.” That was somewhat of a relief, since my online research about that particular marker yielded very confusing results.

A nurse from my HCP's office did call to discuss my results with me, and we agreed that nothing needed immediate attention, other than to watch my diet and take some extra vitamin D.

I can understand the concerns of health care professionals that not everyone will understand or properly interpret lab test results. That's why we need HCPs. But, for those times when human errors or system errors occur, and those lab results don't get delivered by the HCP, this is a nice backup. Some doctors agree that it will allow for more informed health discussions with patients.

As medical professionals increasingly adopt safe and secure electronic systems, these results can be delivered electronically as soon as they're available. The key to making that work for optimal health is figuring out how medical professionals can be made available to quickly discuss the results with patients.

Maybe this is one of many increasing roles for nurse practitioners and physician assistants. Maybe new mobile or online services will help fill this gap.

As Health and Human Services Secretary Kathleen Sebelius said, "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." And that's a good thing.

Comments

I am so excited about this development! As a dietitian I would always tell my patients to get copies of their blood work so we could track their progress in areas like blood sugar or cholesterol. But, getting those results was so difficult. And, I had many patients who would say, "well the doctor never called so everything must be fine." Yet, we would later discover that their levels were not ideal.

In my own health care I have always felt that not having access to the blood work that I had payed for was criminal. I am educated enough to understand what the labs mean, and even if that weren't the case I should have the right to question the labs and consult with my doctor as needed.

I have always kept copies of my labs, which is a practice I recommend to everyone as it has been extremely helpful when seeing new specialists who didn't have access to my medical records, or in tracking changes in my health. However, in the past hunting down those copies often meant disturbing medical office staff and making lots of phone calls. Now I can just go right to the lab.

I think this new law is really a win for consumers and health care providers and a much-needed step toward more transparency in our health care system.

Michelle,I'm so happy to hear from a dietitian and to hear how it can help you help patients. Beth Battaglino, who is a nurse and CEO of boutron agrees that women need this information -- and they need the precise numbers. Just knowing that you're in the normal range, may not tell you everything you need to know. For example, if my LDL cholesterol is just 1 or 2 numbers away from being in the danger zone, I would want to make changes in my diet and exercise to prevent it from getting worse -- rather than waiting and possibly having to go on statins.

You make a great point about being able to get and keep copies of records. Once we have them, we can talk intelligently with health practitioners about what they mean and what the next steps are.

It's about time. This is the way it should be! So, how do patients actually obtain the results w/out their doctors? Get them directly from the lab?

I do agree that it would be helpful for PAs or nurse practitioners to have a direct role in discussing the results with the patients. They're too hard to interpret for the average layperson, after all.

Sheryl, I'm not sure how you obtain the results. Some states and practices have been doing this for a while, and I have been getting copies of mine for a couple of years. I think I signed something at my doctor's office saying that the lab could release them directly to me. Check with your doctor (and/or the lab) next time you go in for tests. From some initial feedback I've heard from practitioners, many people can easily understand the basic blood work results, where ranges are given and you can see where you fall. It's the more complex testing, like radiology reports, that can be hard for the average person to interpret. We're working on an article for boutron that will explain this further. Stay tuned.

Any step toward individuals taking control of their health care is a good thing. This is an opportunity for doctors and patients to work together to find the best solution for each individual person. With doctor shortages and so many changes still to come it will interesting to see how this plays out.

Martha, I agree that anything that empowers us to control our own health care is a good thing. Having this information can only help us work with our health care providers to find the best options.

I always get my lab and test results. Since my breast cancer five years ago I see multiple doctors connected to different health centers.. They don't communicate with each other. So if one doctor orders a test or lab I bring the results to the other doctors.

Except when you go to the trouble to request a form, wait for the form, send back the form, wait for the results to arrive, and then are only informed of what you already know: that the test was positive.What excatly was the test positive for?  This is how these companies are getting around actual right to know. 

 

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