Positive tests

Knapp, Lucy LKnapp at PEACEHEALTHLABS.ORG
Mon Mar 9 16:37:10 UTC 2015


As a medical technologist, I have for years looked up my own results after they were done. As I've been doing this for so many years, I have a pretty good grasp on laboratory results. And I do have a great relationship with my PCP which makes for good communication. All my test results are available through patient portals promptly and I think that is generally a good thing.  I did have a recent issue that I thought was cause for some concern. I had a baseline ECG done at the office and the following day the results were on the portal. It was rather disconcerting to see the words "consistent with inferior infarct" on the report. As he had not called me and I felt more or less OK - I did not panic, but started looking on line. There I discovered that obesity often causes the changes seen on the ECG, and sad to say I do have that problem. I only bring the issue up because with electronic portals, doctors need to be aware that patients will have results sometimes ahead of them. I suspect they may be getting more phone calls from concerned patients. I think some care in how results are presented could help there.

That said - we professionals need to test and retest all the interfaces results go across to insure the results that get to the patient are the same results released from the laboratory or radiology. There have been problems. We are currently changing our HIS and LIS here to an integrated system --- The watchword is test until you're sick of testing, then test some more :)

Lucy

[Description: PHLlogo]

Lucy Knapp
Technical Specialist, Chemistry
Vancouver Laboratory

360-514-2732 Phone

lknapp at peacehealthlabs.org<mailto:lknapp at peacehealthlabs.org>
www.peacehealthlabs.org<http://www.peacehealthlabs.org/>
400 NE Mother Joseph Place
Vancouver,WA 98664

From: robert bell [mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Sunday, March 08, 2015 12:28 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Positive tests

Great Post Peggy,

Do you think the Portal internet revolution will change anything for the better or worse? Also, Dr. Pronovost first did a study at Johns Hopkins with his catheter infection study before it was expanded to save so many lives. Do we know if studies were done with the new Portal initiative prior to going public/nationwide to work out any kinks?

Brings up the issue of what level of study needs to be done to recommend anything to prevent errors in diagnosis (or for that matter all errors in medicine). Can you recommend to all something which just seems common sense without studies?

Rob B

Brings up the issue that I have mentioned before regarding standardizing procedures and building in double checks etc. Theoretically, that could be done tomorrow.
On Mar 8, 2015, at 10:52 AM, Peggy Zuckerman <peggyzuckerman at GMAIL.COM<mailto:peggyzuckerman at GMAIL.COM>> wrote:

There are studies which show that up to 15% of labs which indicate abnormal findings are not conveyed to the patient.  One hopes that this info is not always critical.
On a larger scale, when the patient never receives a copy of the labs, there is no reason for that patient to feel at all responsible for the numbers!  In effect, this teaches the patient that he is not responsible for his own healthcare, with often disastrous consequences.
Of course, a patient who can compare lab results over a period of time may note trends that are missed by the doctor's review, or note something else that was not initially of concern during the previous appointment.  Could be cholesterol, WBC, or platelets, when the appointment was about blood pressure issues.
Not only should blood labs be given to patients, so should  radiology reports.  Cannot tell you how many times patients in my kidney cancer group indicate that there was a tumor noted on a report, but never mentioned by the doctor. Perhaps a too-cursory look by the doctor, but such a finding would be noted by the patient, questioned and lead to an earlier diagnosis.
Peggy Z


On Sun, Mar 8, 2015 at 8:46 AM, Robert Bell <rmsbell at esedona.net<mailto:rmsbell at esedona.net>> wrote:
Many doctor's offices only call or mention to patients positive test results that have been undertaken (particularly lab tests). Is that a good thing and does it in any way impact diagnosis?

Also, what are the effects of the new electronic portals on diagnosis. It is a big change in medicine.

Rob Bell

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Peggy Zuckerman
www.peggyRCC.com<http://www.peggyrcc.com/>

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