This issue has generated such interest that I have actually gone and got our
Trust Legal advisors to comment. They maintain that the person to provide
information to patients should be in a position to provide all the information
rather than merely a fragment which may be in conflict with the 'bigger
picture'. They advise that the GP or the primary requestor of the test is in
the best position to provide such a complete picture.
Regards
Mike Ryan
Antrim
Gordon Challand wrote ">"
>1. General information about a Pathology test (eg when a result may
be available) may only be given >to the patient himself (exception, the
parent of a young patient).
Patients often phone to find out when their results will be available
so they can make their next appointment. Most likely the patient would
be told when that/those test/s would be completed.
In these days of electronic transfer of results it is not uncommon for
the referrer to hit the print button on their computer and generate a
report copy then the patient phones the lab to seek an interpretation
either because the referrer "was too busy" or because they did not agree
with the referrer.
>. Specific information: what a result is and what is an opinion based
on this, should never be given to > patient or anyone else other than a
member of his clinical team. There are many exceptions. Two >obvious
ones are
>a. The patient who is monitoring/ modifying his own treatment on the
basis of laboratory results. >Such information may be given to the
patient (this is with the implicit (but probably should be made
>explicit) consent of the clinical team).
I am glad that someone has mentioned the obvious case there results
could be given directly to an informed patient (this would only occur on
the express consent of the referring medical practitioner) -
Monitoring. Take the case of Warfarin therapy the doctor can predict
an range of doses of warfarin to attain the target PT - the referrer
arranges for the patient to contact the testing laboratory to be
registered. The patient then deals directly with the laboratory
following collection of the PT and the laboratory staff will advise of
dosage required to maintain target time. I am a little hazy on
coagulation tests, but I know that the laboratory I work for does just
this with over 600 patients.
In my experience the only other test their the referrer is likely to
give permission for the patient to be given the result over the phone is
pregnancy testing - one suspects that in these cases the referrer has a
strong clinical suspicion as to the outcome of the testing. Another
group of patients which have high interest in their results are those on
Infertility programs (IVF, AI) where today's results determine whether
tomorrow's testing is required.
Most of the examples used by respondants dealt the tests primarily
used for diagnosis eg HIV, tumour markers etc. On the subject of HIV no
laboratory in the State of Queensland can release a positive HIV result
(referral to State controlled AIDS Medical Unit is mandatory). Upon
confirmation of a positive result (may take up to two weeks after
referral) the result will not be released until the referring medical
practitioner is phoned.
Michael Freemantle
In the event of any general query, for example
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META contentÿSHTML 5.00.2614.3500" nameþNERATOR>
<STYLE></STYLE>
</HEAD>
<BODY bgColorÿfffff>
<BLOCKQUOTE
styleûORDER-LEFT: #000000 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT:
0px; PADDING-LEFT: 5px; PADDING-RIGHT: 0px">
<DIV><FONT faceÿial sizeÿGordon Challand wrote
">"</FONT></DIV>
<DIV><FONT faceÿial sizeÿ>1. General information about a
Pathology test
(eg when a result may be available) may only be given >to the
patient
himself (exception, the parent of a young patient).</FONT></DIV>
<DIV><FONT faceÿial sizeÿ</FONT> </DIV>
<DIV><FONT faceÿial sizeÿPatients often phone to find out when
their
results will be available so they can make their next
appointment. Most likely the patient would be
told when
that/those test/s would be completed. </FONT></DIV>
<DIV><FONT faceÿial sizeÿIn these days of electronic transfer
of results
it is not uncommon for the referrer to hit the print button on their
computer
and generate a report copy then the patient phones the lab to seek an
interpretation either because the referrer "was too busy" or because
they did
not agree with the referrer. </FONT></DIV>
<DIV> </DIV>
<DIV><FONT faceÿial sizeÿ>. Specific information: what a
result is and
what is an opinion based on this, should never be given to >
patient or
anyone else other than a member of his clinical team. There are many
exceptions. Two >obvious ones are</FONT></DIV>
<DIV><FONT faceÿial sizeÿ>a. The patient who is monitoring/
modifying
his own treatment on the basis of laboratory results. >Such
information may
be given to the patient (this is with the implicit (but probably
should be
made >explicit) consent of the clinical team).</FONT></DIV>
<DIV><FONT faceÿial sizeÿ</FONT> </DIV>
<DIV><FONT faceÿial sizeÿI am glad that someone has mentioned
the obvious
case there results could be given directly to an informed patient
(this would
only occur on the express consent of the referring medical
practitioner)
-</FONT></DIV>
<DIV><FONT faceÿial sizeÿMonitoring. Take the case of Warfarin
therapy the
doctor can predict an range of doses of warfarin to attain the target
PT - the
referrer arranges for the patient to contact the testing laboratory to
be
registered. The patient then deals directly with the laboratory
following
collection of the PT and the laboratory staff will advise of dosage
required
to maintain target time. I am a little hazy on coagulation tests,
but I
know that the laboratory I work for does just this with
over 600 patients. </FONT></DIV>
<DIV><FONT faceÿial sizeÿIn my experience the only other test
their the
referrer is likely to give permission for the patient to be given the
result
over the phone is pregnancy testing - one suspects that in these cases
the
referrer has a strong clinical suspicion as to the outcome of the
testing.
Another group of patients which have high interest in their results
are those
on Infertility programs (IVF, AI) where today's results determine
whether
tomorrow's testing is required.</FONT></DIV>
<DIV><FONT faceÿial sizeÿMost of the examples used by
respondants dealt
the tests primarily used for diagnosis eg HIV, tumour markers etc. On
the
subject of HIV no laboratory in the State of Queensland
can release a
positive HIV result (referral to State controlled AIDS Medical Unit is
mandatory). Upon confirmation of a positive result (may take up
to two
weeks after referral) the result will not be released until the
referring medical practitioner is phoned.
</FONT></DIV>
<DIV> </DIV>
<DIV><FONT faceÿial sizeÿMichael Freemantle</FONT></DIV>
<DIV> </DIV>
<DIV><FONT faceÿial sizeÿIn the event of any general query,
for example
</FONT></DIV></BLOCKQUOTE></BODY></HTML>
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|
