The 21st Century Cures Act went into effect in 2021. Among other things, the federal law requires that patients have access to their test results in a timely manner. In years past patients often had to play phone tag with their doctor’s office to view their own medical records and lab test results. Before the 21st Century Cures Act, patients often never knew the results of tests if the doctor did not consider them noteworthy. Indeed, some states had laws against direct patient access.
It would be great if our health care providers always called immediately to discuss our lab results, but sometimes they don’t. One study found that 1 out of 14 patients with negative results never received that information from their doctors.
Many doctors were not too keen on direct patient access to laboratory testing results and other health information. It was not that doctors did not want their patients to have this information. It was more of a case that doctors preferred to filter the information that patients receive. There was the perception that patient access could result in too many questions. The following article discusses some of the concerns:
Some doctors and physician organizations had raised concerns that patients would be unable to interpret lab results without help from HCPs. They feared that a patient might act on a report showing abnormal results, when actually those results could be normal for that particular patient—or could be a false negative or false positive that might require additional testing or analysis.
The Obama Administration was the first to boost access to test results a decade ago. At the time, some states already had the right to access lab results, while other states required doctors to make that decision. Some states had laws against releasing results directly to patients. The 21st Century Cures Act guarantees access, sometimes before your doctor has reviewed them.
I keep records of my annual blood tests and take the results to any doctor I see during the year. My wife keeps records of her blood tests and makes sure copies are sent to other doctors she sees during the year. She also keeps medical records of all lab work for her horse and our cat and dog. Yet, she sometimes gets pushbacks from veterinary offices when she requests copies of x-rays and lab results she paid for. Sometimes what the doctor dismissed as “in the normal range” was barely within the normal range and deserves some discussion.
Nowadays all the lab reports have a range of normal and show the result against that range. Patients can view their result against the range and even go online to compare results with disease and conditions. For example, I recently got an email from a doctor apologizing for having not told me a month ago that one metric from a blood test was slightly higher than normal. His message explained my result – although higher than normal – is usually considered beneficial. I used Google to learn more about my results and discovered something in my diet that could cause it.
I do not always see a doctor every year. I do, however, have extensive blood testing and lab work done on an annual basis. Cancer runs in my family. Three aunts and an uncle have died of cancer. A couple of members of my immediate family have been treated for cancer. For peace of mind I took a blood test that looked for cancer DNA in my blood for more than a dozen different common cancers. It found nothing and estimated my probability of getting cancer within the next year was 1 in 200. Stated another way, my odds of being cancer free next year was 99.5%. It almost certainly could have estimated my odds over the next decade but doing so would make me less likely to buy the test again next year or the year after.
Direct-to-consumer lab tests are empowering. They provide peace of mind and boost access to care. These tests would not be possible if direct access to test results were not codified into federal law.
For further reading see CBS News: Immediate access to test results “comes with some wrinkles,” doctor says
Also see: You Have a Right to Your Lab Results: New Rules Provide Direct Access