Patients who receive test results instantly: Doctors need to be ready

While again written for the US context, where patients pay – directly or indirectly – for the individual tests, does capture the ideal state that all patients want: immediate (or within 24 hours) results and interpretation of medical tests.

To a certain extent, this ideal is particularly important should results be abnormal, or when a disease is first diagnosed. At my Blood and Marrow Transplant clinic, visits are spaced frequently enough that I rarely have to wait very long, and I am far enough in the process not to get too worried each time I have a scan etc. And if something is out of whack (e.g., low blood counts), they call me with the results and the proposed treatment, usually within a day or so.

For women diagnosed with breast cancer, patients see the oncologist the same day, after a wait of about an hour or so depending on the number of people, to interpret the results, greatly reducing anxiety time. Another best practice.

And we are fortunate to have a family doctor who shares the philosophy and practice below:

We physicians can and should provide better service in getting all test results back to our patients quickly. Every clinical setting is unique, but there is no valid reason why any result should not be communicated back to the patient on the day it is received, preferably within minutes. In our clinic, we do not put off today’s work until tomorrow: “same day scheduling” means the patient who calls today is seen today. “Same day response” means phone calls, emails, electronic messages and all incoming testing results receive responses that day. It is true some “later in the day” lab and radiology results must be sent electronically in the evening and on weekends, often from a provider’s home, but that is the care commitment we make to our patients. Not only does that allow us to respond quickly to a significant abnormal that needs follow-up, but it allows us to address the insignificant abnormality, reassuring the patient that we are on top of what is happening for them. Any practice frequently sees labs and xrays with results outside of the normal standards. The clinician who has seen the patient, has done the physical assessment, and is aware of the past history is in the best position to interpret and specifically address the significance and need for follow up of anything “out of range.”

The only way this can be done efficiently and easily is with a robust electronic medical record system with integrated lab and radiology results, along with a password secured patient web portal that allows that information to be viewed by the patient.

I’m an enthusiastic advocate of patient autonomy, providing as much information as possible as soon as possible. The advent of patient access to instant electronic results necessitates that clinicians be ready to help stem the tide of confusing information flooding indiscriminately to the patient. We need to be ready for the fear, the anxiety, the questions and even for the relief when things look fine.

After all, that’s what we trained to do. And we’re happy to do it.

Patients who receive test results instantly: Doctors need to be ready.

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