Opposition grows to real-time pathology data sharing plan

A plan to make pathology reports immediately accessible through My Health Record is facing opposition from GPs and specialists, with three peak bodies warning the move could lead to misinformation and patient stress.

The Royal Australian College of General Practitioners (RACGP) and Royal College of Pathologists of Australasia (GCPA) this week joined the Australian Medical Association (AMA) in opposing the removal of a seven-day delay for uploads without exemptions for certain tests.

The federal government began consulting on the reforms, which will also require pathology providers to upload patient results to My Health Record by default, in September to “make My Health Record more consumer-centred”.

The seven-day delay was introduced in 2014 to ensure healthcare providers responsible for follow-up care have time to review diagnostic imaging and pathology results and discuss them with patients before becoming available on My Health Record.

But the rule has since been removed for a small number of tests, including pathology results for COVID-19 and 13 other respiratory pathogens, and calls to remove the delay on other tests have been increasing, according to the Department of Health and Aged Care.

“Timely access to diagnostic imaging and pathology reports empowers consumers to better manage their own health and protect others in the community. It also helps them have informed discussions and make decisions with healthcare providers,” the consultation paper said.

While supporting the removal of barriers to information access, RACGP and RCPA, as well as the AMA, argue the current proposal to remove the seven-day delay would likely result in misinformation and patient stress.

All three associations have argued that some tests, including those that result in complex reports that are often discussed by clinicians to determine an appropriate path forward, be considered for exclusion if the seven-day rule is removed to avoid.

RACGP president Nicole Higgins said that the current seven-day delay gives GPs and patients a vital opportunity to discuss results, with much of the terminology entered into My Health Record “written for doctors, by doctors”.

“A pathology result can be stressful, so there’s real value to having a two-way discussion with a trusted medical professional. There is also a worrying amount of vague, unapplicable, and outrightly incorrect information online,” Dr Higgins said.

“If this change does go ahead, at the minimum it should not happen without an education campaign for patients so they can understand the risks of interpreting their own results. There will need to be clear advice in the My Health Record advising patients to discuss results with their doctor.”

RCPA president Associate Professor Trishe Leong said that if the delays are removed, it is critical that “consumers are advised to review their results with their GP or other specialist”, and are provided with contact details for general supports services, such as GPs and Lifeline.

She said that while there is the potential for improved patient outcomes, unintended consequence, such as a patient misinterpreting the results and failing to return for a clinical appointment, must be considered, Professor Leong said.

The AMA, which voiced its concern in October after the majority of responses to a survey of its members were negative, has recommended “strict protocols” be established and that the default should be to delay patient access to results by seven-days where there is any uncertainty.

“In an attempt to balance the need for clinical review of results with patients having timely access to these, the question has been raised as to whether upload could be linked to referring clinician review of results and sign-off to upload (where this occurs before seven days),” it said.

“AMA members have also suggested potentially allowing for immediate clinician access via My Health Record, enabling a clinician – other than the referring clinician – to review it, but delay patient access for seven days.”

The three peak bodies have raised no concerns with plans with proposed changes that will see pathology and diagnostic imaging providers forced to upload patient results to My Health Record by default from June.

Currently, only half of all pathology reports and one in five diagnostic imaging reports currently make their way onto My Health Record, the use of which has been patchy since it was introduced in 2012.

Legislative changes are being considered by government to force pathology laboratories and diagnostic imaging to upload to My Health Record by “linking eligibility to receive Medicare rebates to sharing of diagnostic imaging or pathology reports”.

The government is planning to upgrade the national digital health platform to “make health information much more accessible to consumers and their healthcare providers”, including by replacing the clunky pdf format system with a structured data system.

Following a report by the Strengthening Medicare Taskforce, the government set aside $429.7 million over two years to modernise the My Health Record, building on improvements over the last three years.

Do you know more? Contact James Riley via Email.

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