In a move designed to give patients more control over their medical records, individuals will be able to obtain copies of their medicals test results directly from the testing lab, according to a rule recently adopted by HHS(www.federalregister.gov).
Although patients can continue to obtain laboratory results from their physicians, a patient or a patient's designated representative now can request test results from the lab that administered the test without contacting the requesting physician, according to the rule. Lab tests covered by the rule include any tests used to diagnose, treat or prevent a disease. Employment-related tests, such as drug screenings, are not subject to the new rule.
"We support the rule, and we support transparency," said AAFP President Reid Blackwelder, M.D., of Kingsport, Tenn. "The patient has the right to the information, but the physician still needs to communicate with the patient to put the results into the right perspective."
Although HHS noted that patients still prefer to receive lab test results from their physician so they can discuss any necessary treatment or other follow-up, some physicians do not explain test results that are within normal limits. The new rule gives patients another option to obtain their results if their physician does not follow up with an explanation, said HHS.
- A new HHS rule seeks to facilitate greater transparency regarding medical lab tests.
- Patients now can obtain their lab test results independently without making a request through their physician.
- The AAFP supports the rule with reservations, saying it is important that physicians explain what the test results mean.
Blackwelder emphasized that effective medical care needs to include communication between the physician and patient. "I give copies of the lab reports to my patients and then tell them that either I will call them or a nurse will call to explain the results," he said.
Physician practices could set up an online portal so patients could log on to a secure site to view their lab results, Blackwelder suggested. A member of the practice team could write short descriptions about the results to explain their significance.
The new rule also allows patients to choose whether they want their lab reports mailed or emailed to them. If records are sent via traditional mail, the lab can impose a fee for postage. Although HHS encourages labs to provide access to records through a secure patient portal, it does not require them to do so.
Nine states and U.S. territories already allow patients to access their test results directly from the lab. Another 26 states and U.S. territories have no law on the issue. Thirteen states require that lab results be sent to the physician only, and seven states permit patients to access their lab results only with approval from their physicians.
The lab test results rule was proposed by HHS in 2011. At that time, the AAFP supported the rule with reservations, specifically citing the risk associated with providing patient test results without any accompanying explanation about their implications.
The final rule applies only to laboratories and does not override state laws that require physicians to counsel patients about specific test results, such as patients found to be infected with HIV.
When a patient requests test results, a lab has 30 days to comply. HHS could impose a fine on labs that charge an excessive fee for copies of test results, for a delayed response or for failure to respond to a patient's request.
In addition, even if the patient has not paid for all services provided by the lab, the lab may not withhold test results. Labs are not required to notify the physician when a patient requests his or her records, but they have the option to do so.