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When you're not first ...

March 15, 2010
by stacey
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I don’t mean to show off, really I don’t, but when I was logging onto my PHR (yeah, that’s right, I have one!), I discovered two things: that not everything’s there — OK, not a major shock, but that I don’t get to see things before my docs (or at least I haven’t been able to thus far). It might have just been a spoof, or simply dumb luck that the information that I got and the results of several tests, was not posted (it was posted, but didn’t let me ‘view’ until after I’d actually seen my doctor. In one case, it didn’t let me view the results until (long) after I received a postal letter. Maybe these are isolated incidences, or maybe the system is designed so that the patient isn’t the first to see things, but is able to keep tabs on things that have already been discussed. Anyone know if this may have been done on purpose (or why) or have any thoughts about it? Maybe it’s to help avoid ‘false positives’ and help quell unnecessarily panicky patients?

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Comments

Stacey,

I'm not sure you've shared enough for an informed comment.

Some PHRs are tethered to a care provider. They usually have a policy and a process that is transparent regarding communicating results. Physicians often have 1-2 days to review results from their review and release them.

Tethered PHRs almost always offering scheduling of appointments and messaging with the providers office. This messaging, when related to sensitive clinical information is routed to the physician. Depending on the relationship and agreements, directly getting clinical results within 3 days is common.

Other PHRs are tethered to payers, such as Aetna and Cigna.

Still other PHRs are not tethered. It then becomes a contractual issue, to opt-in or opt-out from result message delivery, if the care provider is able to and chooses to offer that service.

The FFS world, the Advanced Medical Home, as well as other deliver models vary in their results delivery processes. Generally speaking, providers actually want you to have your results. They carry a burden to inform you about abnormal results in a timely fashion. This can be very hard and expensive for them.

Lastly, you can insist that when your labwork is sent out that the results are faxed to you directly, or decline getting the blood or urine collected. I appreciate that faxing is old-school for a pHR person it does tend to be the defacto available standard. It might be illegal for providers to force you to use their lab.

Stacey, I think that's not very different from calling the lab for results. They always direct you to get the results from your doctor. Whether that's physician hierarchy or not, it does make a lot of sense. Though it may seem like simple tests like "am I pregnant or not?" would be your "right to know," there are many test results which entail a deeper analysis and I personally think need a doctor's analysis, explanation and hopefully, follow up. I believe most systems are set to get physician sign off before the patient can review.

Thanks, Daphne. Thanks, Joe. Very interesting comments. I believe this system is tethered to the hospital. The results were of lab tests (at the hospital) and of imaging (one, I believe was connected to the hospital, the other was not). Yes, I was happy to hear the results from my doctor in 2 out of 3. Well, sort of. The lab tests (blood), I still don't know the results of (not online). I'm guessing I'm not dying because I'm still here. Bad joke. The former imaging is now up and I can view the report, but I received a letter first (and that alone scared me to death). The latter is now up (after seeing my doctor), but I couldn't interpret the results myself anyway. I know, I know, I'm not a doctor.

stacey

Stacey Kramer is Managing Editor of Healthcare Informatics. She writes feature stories and...