Direct-to-Patient Laboratory Test Reporting

MJYPetrie-Flom Student Fellow Michael Young has coauthored a new piece with Ethan Scheinberg (Harvard Law School) and Harold Bursztajn (Harvard Medical School) now available through JAMA, “Direct-to-Patient Laboratory Test Reporting: Balancing Access With Effective Clinical Communication” The article discusses ethical and clinical implications of a 2014 HHS ruling allowing patients direct access to completed medical laboratory reports.

From the article:

The rule was motivated by concerns that some patients were not receiving test results or adequate interpretation from their clinicians. Yet the rule also makes possible a new dynamic in such cases wherein the interpretive burden is shifted from clinician to patient. One risk is that some clinicians may over-rely on patients to initiate the interpretive process, thus permitting circumstances in which patients avoid necessary medical treatment because of embarrassment, denial, or other motivations. Although this is an issue in all stages of medical treatment, the problem is especially pronounced regarding test results. Test results are often complicated, and their interpretation requires much external knowledge of normative patterns, statistical principles, and individual distinguishing factors. In settings of internally ambiguous or technically nuanced tests, the task of anticipating the meaning of results in advance may be fraught with difficulty. In effect, clinicians can only counsel patients beforehand from positions of uncertainty.

Read the full article.


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