Pathologists back GP’s concerns over real-time results

4 minute read

The pathology college supports the RACGP’s bid to keep the seven-day delay on the release of My Health Record reports.

While GPs and pathologists alike are on board for better patient access to pathology results, immediate access without the opportunity to discuss results with a doctor could lead to panic, the Royal College of Pathologists of Australasia and the RACGP have said in a joint statement.

Last October, the Department of Health and Aged Care concluded its initial consultation into plans to modernise My Health Record.

Since then, the federal government has promised My Health Record two years of dedicated funding and has announced it will require providers to upload diagnostic imaging and pathology results to the platform.

In its response to the initial consultation, published last October, the RACGP supported the push to require providers to share pathology and diagnostic imaging.

But it emphasised the importance of GPs being given the time to discuss results with patients prior to My Health Record access, encouraging the government to retain the seven-day delay rule.

Currently, the seven-day rule enforces a week-long delay for patient access to most pathology and diagnostic imaging reports on My Health Record.

The RCPA has now put its weight behind the cause, with both colleges issuing a joint warning opposing the removal of the rule.

“GPs and other specialists don’t seek to be medical gatekeepers, but we are there to support our patients to understand their results, treatment options and next steps,” said RACGP president Nicole Higgins in the release.

“Much of the terminology entered into My Health Record is written for doctors, by doctors, and has to be understood in the context of a patient’s medical history and other health factors and conditions,” she added.

“The seven-day delay gives us and our patients time to make an appointment where we can sit down and have those important conversations.”

Should the rule be scrapped, the colleges have requested a broad consultation on tests that should be excluded from the rule, such as anatomical pathology and cytopathology reports which often require discussion between specialists to decide the next clinical course of action.

The colleges also suggested that genetic results remain at the behest of the seven-day rule as they “often carry broader, more long-term, and more complex implications”.

“Genetic test results are often probabilistic, have consequences for family members, have potential psychological impacts, can have unanticipated implications, and vary in their actionability and therapeutic options,” said RCPA president Associate Professor Trishe Leong.

“Post-test counselling is therefore considered crucial to prevent potential patient harm from specific genetic tests and results,” she added.

“Pathologists and requesting doctors are best placed to determine when specific genetic tests or results require post-test counselling.

“To allow for such counselling, providers should have the discretion to delay releasing results for up to seven days when clinically warranted.”

Professor Leong added that while there may be potential for quicker results to improve care, it was imperative that misinterpretation was avoided, which may require that additional information be provided with the results.

“It is critical that if these delays are removed, consumers are advised to review their results with their GP or other specialist and are also provided with evidence-based information on pathology testing such as Pathology Tests Explained, and contact details for general support services, such as GPs and Lifeline,” she said.

“We must consider the unintended consequences of a patient failing to return for a clinical appointment because results are within the normal range or misinterpreted.

“This significantly impacts patient care and requires a system for monitoring.”

Professor Leong added that there would also likely be impacts on health professionals.

“The impact on healthcare providers needs to be considered, with increased communication from patients to the referring healthcare providers or directly to the laboratories, wanting to know the meaning of an unexpected abnormal result,” she said.

Both colleges requested that they be included in any future consultations on the matter.

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