Paula Findlay, an elite tri-athlete, expected to win a medal, probably gold, in the 2012 Olympics. Her disappointing performance (she came last) was blamed on low levels of iron in her blood. Worst of all, blood tests several months prior to the event showed that she had low iron. Paula Findlay has a personalized team of doctors and trainers, yet, when it was most important, everyone ignored an abnormal laboratory result.
Every year some Canadian patients, are harmed or die unnecessarily, when laboratory results are lost, ignored, or not communicated to patients. If an elite Olympic athlete, one who has access to an expensive and personal health care team, suffers from a poorly handled lab result, what chance do the rest of us have?
You can communicate, using secure e-mail, with banks, credit unions, most lawyers, stock brokers, credit card companies, and anyone else who values your well-being and your business, but not your doctors.
Twenty years ago the Supreme Court of Canada ruled that Canadians have the right to access their own medical records. The justices said, “a patient is entitled, upon request, to…all information in her medical records”. Nevertheless, in Nova Scotia the laboratories and x-ray departments that capture and create reports about your health will not send the results directly, even if you and your doctor ask them to.
One way to avoid lost, mislaid, and ignored laboratory results is to ask laboratories to send results not only to the doctor but also the patient. Modern information technology enables laboratories to include a brief explanation of the meaning of any test. Patients who had a laboratory test, and did not receive a result would find out why a result was not forthcoming, and if they received an abnormal report they would be prompted to see the clinician for an interpretation. A laboratory spokesperson alludes to provincial budgetary constraints, in Nova Scotia, as one reason for failure to introduce electronic communication
The Co-Operative sector (that would be the group that run successful community owned credit unions) recognized the harms to people when laboratory results are lost, mislaid or ignored and has invested heavily in a project that would enable patients to receive pertinent information. Today, a co-operative owned organization provides information services to the majority of doctors, who in turn care for a large majority of patients in Nova Scotia. The cooperative organization is developing the capacity to enable physicians to e-mail laboratory results directly to patients. However, In order to transfer information to patients, they must receive it in a standard electronic format.
Unfortunately, the Provincial government, behaving as any other monopoly has been unable or unwilling to provide the information in a standard format. Essentially the Province is announcing that the laboratories the Province owns will not send results directly to patients, and neither will anyone else.
Patients can protect themselves even though Nova Scotians must contend with medieval information systems. Whenever you have laboratory investigations, make sure that your doctor has physically received the laboratory result, and reviewed it. For most patients, this means making and appointment, seeing your doctor in person, and seeing the laboratory test result.
David Zitner, a family physician, is Health Policy Fellow with the Atlantic Institute for Market Studies and a professor in the Dalhousie Faculty of Medicine.