Access to medical records under proposal

Should patients have unrestricted access to their electronic laboratory test results?

The U.S. Department of Health and Human Services thinks so, and HHS Secretary Kathleen Sibelius proposed a new rule Sept. 12 that would allow such access.

“When it comes to health care, information is power,” Sibelius said at the first-ever HHS Consumer Health IT Summit in Washington, D.C. “When patients have their lab results, they are more likely to ask the right questions, make better decisions and receive better care.”

Sounds good, but some in the medical profession aren’t so sure, expressing concerns that some patients could become confused or misinterpret what they see in their reports.

Such confusion could lead to an overreaction to what they mistakenly interpret as an abnormal result or on the other hand think that the report contains no cause for alarm when it actually does.

Public comments regarding the proposed rule will be taken until Nov. 14. A spokeswoman for the American Medical Association said the AMA is “currently reviewing the rule” and has yet made no comment.

In Northern Colorado, the presidents of the Larimer and Weld county medical societies are in agreement that more open access by patients to their records is fundamentally an improvement in patient care.

“I think it’s a good thing that patients should be allowed access to their records,´ said Richard Budensiek, M.D., president of the Weld County Medical Society. “I think we need to empower patients to do these kinds of things. I think it’s a positive change because soon there’ll be even more access to their records.”

Robert Benz, M.D., Larimer County Medical Society president, agrees.

“I think overall it’s helping patients get involved in their health care, and getting involved in what’s going on is a great thing,” he said. “We encourage that.”

But Benz adds a note of caution.

“We’re all in favor of transparency,” he said. “But the issue is any time you get medical information back it needs a filter. Certainly, all of us like to have patients getting involved with their health care. The caveat is the patient focusing on something insignificant.”

Benz said under the new rule he would always suggest that a patient who has any question at all about a test result to schedule an appointment to have the doctor explain what it means.

Budensiek concurs. “It’s important for patients to contact their physician with concerns about any lab tests,” he said. “I think that’s what we’re here for: to enable them and get the extra information they can’t get on their own.”

But Budensiek said he’s seen patients sometimes take matters too much into their own hands.

“I have patients who get what they think is an abnormal lab test and get on the Internet and get into things that could be potentially harmful,” he said, referring to unproven medicines and other products.

Speeding up the conversion of medical records from paper to digital records, which can be more easily shared among medical providers and that are more accessible to patients, has been a centerpiece of the health-reform act signed into law in 2010.

Electronic conversion

Both Benz and Budensiek are strong advocates for health-care reform and moving to an electronic health records system.

“I think this is a good jumping-off point,” Budensiek said. “We’re approaching a health-care crisis in America, and we don’t have the doctors to help patients through every little nuance. Restricting a person’s access to their lab results is not going to fit into the new model of health care reform.”

Budensiek, who said his office made the conversion to electronic records a year and half ago, acknowledges it is the future of medicine.

“As difficult as it was for me going from paper charts to digital charts, it’s something we need to do,” he said. “If we don’t have a robust system like electronic medical records, it’s time-prohibitive to go through thousands of charts to see what’s been done.”

Both doctors say they support the idea of teamwork between physicians and patients to get the best result.

“Unfortunately, some things fall through the cracks,” Benz said. “If patients have access to their records and if a test doesn’t come back, they can check it out themselves.

“Teamwork is one of the goals of health-care reform, to have more integrated care. I think the issue is many patients don’t take control of their own health, and hopefully this will help with that.”

Steve Porter covers health care for the Northern Colorado Business Report. He can be reached at 970-232-3147 or at sporter@ncbr.com.