December 18, 2023

Should Primary Care Physicians Review All Test Results?

Physician burnout is a significant issue affecting healthcare professionals worldwide. It's characterized by extreme physical, emotional, and mental exhaustion, primarily driven by modern medical practice's relentless demands and stressors.

Notably, in addition to factors such as heavy workloads and extended working hours, another key contributor is the time-consuming task of addressing test result notifications via EHR-based inboxes, which adds to the prolonged working hours of physicians.

Research has underscored the significant role played by EHR inbox burdens in exacerbating physician burnout and influencing decisions to either reduce clinical hours or exit the medical profession entirely. Studies analyzing primary care physician (PCP) inbox management have revealed that a substantial portion of their time is devoted to addressing test results, compounding the strain on healthcare providers.

But do primary care physicians need to receive and review the test results ordered by other healthcare providers for their shared patients?

Let's dig deeper to discover the reality.

Background of Test Result Communication

When it comes to medical test results, ensuring they reach the right people at the right time is crucial for patient safety. The Joint Commission recognized its significance in patient safety and made it a National Patient Safety Goal in 2005. They called it "closing the loop" on test results, which means ensuring that these results are received, communicated to patients, and acted upon promptly by the healthcare team. This whole process helps prevent potential missed or delayed diagnoses, which can be a matter of life and death.

It's Drawbacks

Sharing test results among multiple clinicians can be beneficial, but it also brings its share of challenges. It raises the crucial question of who should handle the results, discuss them with the patient, and initiate any required actions.

Should it be the physician who ordered the tests, a non-physician practitioner, or the patient's primary care physician (PCP)?

These uncertainties can hinder seamless healthcare coordination and, most importantly, impact the patient's well-being.

What's the Reality: Should Primary Care Physicians Review All Test Results?

According to the American Medical Association (AMA), no federal rule requires all test results to be sent exclusively to patients' primary care physicians (PCPs).

In reality, the standards outlined in the Clinical Laboratory Improvement Amendments (CLIA), which are part of the Centers for Medicare and Medicaid Services program ensuring quality laboratory testing, specify that laboratory results should be provided both to the clinician who ordered the tests and, as mandated by the 21st Century Cures Act, to the patient.

To ensure clarity in healthcare, guidelines from the Office of the National Coordinator for Health Information Technology stress the need to clearly identify the clinician who ordered a test and, if applicable, the clinician responsible for follow-up in electronic health records (EHRs). Unless the PCP is the one who ordered the tests or is responsible for follow-up, there's no automatic requirement to notify them of the test results.

However, if the patient's PCP requests a copy of a test result from another clinician or healthcare system, it's essential to provide that information promptly. Failing to do so could be seen as obstructing the flow of information, which is against federal regulations. So, sharing requested information with the PCP is vital to ensure proper communication in healthcare.

The American Medical Association (AMA) has launched several initiatives to support physicians and their healthcare teams. These efforts are geared towards providing valuable resources that help eliminate uncertainty and lessen the administrative burdens often encountered.

One noteworthy initiative is the "Debunking Regulatory Myths" series — part of AMA's practice transformation. This series has a clear mission: to offer concise regulatory guidance to physicians and their care teams. Its primary aim is to demystify common misconceptions and provide reliable, accurate information. This initiative equips healthcare professionals with the knowledge they need to minimize guesswork and tackle administrative challenges more effectively.

The ultimate aim here is to free up physicians and their teams, enabling them to channel their energies towards optimizing clinical workflows, enhancing patient outcomes, and elevating overall satisfaction in the healthcare delivery process.

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