The patient portal and Positive tests

Knapp, Lucy LKnapp at PEACEHEALTHLABS.ORG
Tue Mar 10 16:06:03 UTC 2015


I am involved in the laboratory aspects of portals. The regulations required that all interfaces be tested prior to use and at regular intervals there after (we do annual). The problem is that the interfaces are rapidly multiplying – it used to be just between the lab and hospital with faxed reports to offices. Now it’s interfaces to the offices – which all must be tested individually – the hospital, and physician and patient portals. If you add on cell phone apps – you get the picture. You cannot assume that if a result crosses correctly to the hospital system it will cross correctly to the physician portal, or any other interface.

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: Monday, March 09, 2015 9:10 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] The patient portal and Positive tests

Interesting.

An advancement, but patients are like physicians, not all are good "proof readers" - but a true improvement I think. Will more easily interpreted/understood words for patients eventually be used? To me it is a big, big change with immense consequences.

Does anyone know if portals were well tested prior to introduction?

Rob B

Sent from my iPad

On Mar 9, 2015, at 6:18 AM, "Bruno, Michael" <mbruno at HMC.PSU.EDU<mailto:mbruno at HMC.PSU.EDU>> wrote:
Hi Bob,

One thing the patient web portals seem to be changing is the quality and clarity of Radiologists’ written reports.  Because of the portals, the Radiologist’s report is now under more “quality pressure” than ever, since their readership has been suddenly expanded to include a brand new audience—the patients themselves.  Turns out patients are typically much more critical of flaws in the reports than the referring physicians are/were, and so they are providing very powerful feedback to the report writers.  So that’s at least ONE positive development from the portals.  See the attached PDF of an essay I co-authored last year on that topic, which was published in the Journal of the ACR.

Theoretically, if there is enough patient engagement around the portals, errors and misunderstandings might be caught and cleared up before harm is done by having the patient serve as the final ‘proofreader’ of their own medical record.

All the best,

Mike B.
Hershey, PA


From: robert bell [mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG<mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>]
Sent: Sunday, March 08, 2015 3:28 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto: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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