Doctors are at odds with some patient advocates and HHS over a congressional directive aimed at ensuring patients get their medical test results as soon as they’re ready. The physicians say their patients are getting bad news via patient portals before they can explain them since HHS mandated the immediate disclosure of results, implementing a provision in the 21st Century Cures Act that bars providers from restricting patients’ access to their medical information. Doctors and the American Medical Association, which represents physicians, say that: — Patients are getting news about terminal illness or confusing test results. “We’re seeing a parent who finds out at nine o’clock on a Friday night when they can’t reach anybody that their child’s leukemia has recurred,” AMA President Jack Resneck told Ben. — Doctors say they need leeway to hold back information if an immediate release would cause “mental or emotional harm,” pointing to survey data the AMA commissioned showing close to two-thirds of patients want their doctor to talk them through “life-changing” results. “We’re just asking for a little flexibility for a few hours or a few days when there’s bad news to be able to deliver it by phone or in person and to be able to more personally deliver that bad news,” Resneck said. “What we’re talking about is very rare, less than 1 percent of cases.” Some patient advocates argue that could do more harm than good because: — The HHS rule already allows patients to decide whether they want their test results immediately. — “That test result may be what someone needs in order to search for a clinical trial, an emergency second opinion, for a Social Security disability application or to connect with necessary community supports,” Grace Cordovano, a board-certified patient advocate said. — “The regulations do not prevent a physician from having a conversation with their patients when they are ordering particular tests, telling them about the fact that they might get their results in advance of the doctor seeing them,” Genevieve Morris, a former top HHS official and now senior director of interoperability strategy at health IT firm Change Healthcare, said. — Many patients might not have good relationships with their doctors, Morris said, which can affect “whether a patient wants to hear bad news from them or from a computer screen.” Tech roadblock: Resneck said not every system can separate patients who want their results before consulting with their doctor from those who don’t. HHS National Coordinator for Health Information Technology Micky Tripathi expects the market to fix that. “It’s absolutely the case that the electronic health record vendors don’t uniformly have the ability to [let patients decide if they want results delayed],” Tripathi said. “But that’s what demand and supply is all about. Right now, the demand is there. We would expect now the response from the supply side.”
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