Nothing has burned down in the three months since the seven-day My Health Record delay was removed, but the face of pathology may still change.
Thanks to My Health Record modernisation efforts, patients can now access most of their pathology results on the same day as their doctor.
Thanks to AI, patients can also now upload those results to a product like ChatGPT Health and ask a chatbot whether their results are abnormal.
RACGP practice technology and management chair Dr Rob Hosking told The Medical Republic that awareness of My Health Record pathology changes was still low among patients, but that he expected this to change over time.
“As more patients become aware of the MHR change, there will be more opportunities for people to find their results without the support and context a GP or other specialist can provide,” he said.
“With more AI companies stepping into health, and even encouraging people to put input their highly personal test results into their systems, there’s greater risk of someone not having that support from a doctor who knows them when they see a negative or ambiguous result.”
It’s a topic that has been on Perth-based pathologist Dr Michael Page’s mind.
“There’s plenty of anecdotes of patients having looked at their results before they’ve been back to their GP or other specialists to discuss those results, and they’ve either got the result out of context and put it into Google or ChatGPT and, as is easy to do, have drawn the wrong conclusion,” he told TMR.
“Perhaps they’ve been overly made overly anxious by what they’ve seen.
“Perhaps they’ve been too complacent about what they’ve seen, because outside of the full clinical context, any pathology result doesn’t [necessarily] mean what it might initially appear to mean.
“We have heard quite a few anecdotes of that happening, and we always predicted that this would happen [when the seven-day My Health Record delay was removed].”
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Dr Page, who is the CEO of Clinipath Pathology and the immediate past president of AMA WA, has urged colleagues to consider whether there has been a change in their responsibility to patients.
“The rationale for the removal of the seven-day [MyHealthRecord] delay is to empower patients to be in charge of their own information and care,” he wrote in AMA WA’s Medicus publication.
“This is an even stronger reason to consider patient-oriented pathology reporting, which would enable us to inform and arm patients with appropriate, accurate and relevant information to consider before their review with their clinician a few days later.”
Because pathologists are unlikely to have the full clinical context for each patient, Dr Page told TMR, it would be an impossible ask to provide cut-and-dried interpretations for every test.
“But what we can do is take our interpretation of a pathology result, which we provide in technical jargon, and simplify it or put it in more patient-level language,” he said.
“We can make sure that that lay interpretation is accurate and authoritative and reliable, rather than leaving it to chance with ChatGPT with its various hallucinations and misleading conclusions.”
Of course, doing so would mean significant increases in workloads for pathologists.
But where patient use of generative AI can be dangerous, Dr Page hasn’t ruled out using it as a tool on the doctor’s end.
“AI can certainly allow us to do some of these things more efficiently, but without removing the need for medical oversight,” he said.
“We would always want to make sure anything that goes onto a pathology report, we can stand behind as doctors, as pathologists, so we would never just let things go out the door from an AI.
“But what it would be able to do is enable us to certify that the information going out on our reports is … medically appropriate and meaningful and appropriately contextualised [for the patient], rather than just leaving the patient to plug their results into ChatGPT and coming up with something that’s not necessarily helpful.”
From March this year, patients will also be able to view x-ray reports for limbs in My Health Record immediately after they are uploaded, and from July healthcare providers will be obliged to upload all pathology and diagnostic imaging to My Health Record by default.
