How digital technologies can support self-care (3)

15 July, 2020

How digital technologies can support self-care (3)

Clin Chem Lab Med 2019; 57(3): 375-382 Syed Ghulam Sarwar Shah*, Amir Hannan, Bruce Elliott, Ingrid Brindle, Haughton Thornley

https://pubmed.ncbi.nlm.nih.gov/30375343/

Patient Participation Group and Richard Fitton

The view of a general practitioner on immediate access for patients to their laboratory test results

How do patients use their results to augment the consultation and workflow?

Studies show that access to GP records and laboratory test results improves efficiency. Patients use their own data [20] to supplement and complement many stages of the consultation and to improve the safe delivery of care [21].

Online laboratory test result access with informed consent before the test is ordered, and particularly with continuing long-term problems, reduce visits to the GP surgery by allowing patients more time to access and to understand their results and how they will impact on their future care.

The patient spends less time with health professionals. Earlier studies show patients’ comments on the use of their laboratory results and access to their personal medical records [20]. Selected comments are recorded here to illustrate how patients can facilitate healthcare and care pathways through the use of their results and

records (Table 4).

Table 4: Patients’ comments on the use of clinical laboratory results.

Accessing GP records for checking laboratory test results:

“Blood test – EC test - event recorder test.”

“Tests as above and general.”

“I have had various tests over the past 12 months and have been able to access the results to decide on next course of action if necessary.”

“Results have meant review/change to current medication.”

“Able to print off results/reports for consultant without bothering the practice.”

“Consultant reports, consultation notes and lab results.”

“Checks on PSA [prostate-specific antigen] tests (twice yearly).”

“I was not able to access test results from a minor operation that were on my file, having called the surgery these were printed off for me to collect.”

“Able to clarify the situation by reading online reports.”

“Obtaining results for glucose and cholesterol levels, renal function tests; comparing blood pressure readings.”

“Blood test results. Making appointments checking on other results (consultations, etc).”

“I can print out my own results.”

Patients also use access to the GP record to follow the hospital and consultant care pathways:

“Saved bother of requesting reports.”

“Able to obtain copies of reports for consultations with hospital doctors.”

“Consultant reports, consultation notes and lab results.”

“Read consultant letters ref hiatus hernia tests.”

“I check to see if the surgery has received copies of H.... Hospital’s letters that are sent to me.”

For private reports and personal uses:

“Able to obtain reports for insurance purposes. “

“Insurance purposes (but the format of some downloaded reports too big and cannot be resized).”

“Checking my history for insurance questionnaires.”

“Printing out and taking my record away on holiday.”

“I always take my log on and passwords abroad it is useful if I have cause to go to clinics.”

“Checking my medical records for travel insurance purposes.”

For Knowledge management for the patient � using notes to make decisions, understand more or refreshh memory:

“Could look up the type of antibiotic prescribed for further Googling.”

“Also referred back to notes about daughter’s allergies.”

“Test results showed what medication I would need and that it was on an automatic prescription.”

“Reading the results of a hospital stay and what further investigations/medication was required without having to ask.”

“I looked up some previous treatment information rather than ring up or make an appointment.”

“Able to check any past issues I have had or the medication I am taking or gather what I perceive as important.”

“To check I’ve understood everything my doctor told me, and check I’ve not missed anything he said.”

Checking the progress of GP care pathways:

“Checking to see if a letter has been sent or seeing results online so you don’t need to phone.”

“Checked on when I had last asthma check. Booked appointment � it was nearly due.”

“I have been able to read and digest and assess the situation and then make a decision whether to call at the practice. Both times I have felt that I didn’t do anything else.”

“As sometimes I don’t feel that I have all the relevant facts or that the appointment time is not long enough for the doctor to answer all the questions that I might have in full. Or sometimes if I don’t know what questions I should ask, I can analyse all the results on my PC [personal computer] without having to bother or waste the doctor’s time by visiting the surgery. If necessary then I could make an appointment.”

Preparing for consultations:

“By having results from tests prior to seeing a doctor.”

“I require linking the timing with the nurse for the results and then the doctor, this online method has been most helpful.”

“Another benefit by having access to my records I am information before attending either the doctor or a specialists Appointment at the hospital without having to telephone the surgery.”

“To better enable me to understand the cause, make-up and progress of the chronic diseases that I suffer from, and their various medicinal treatments, so that I may be better able to understand and discuss these with my GP at my approx. half-yearly blood/urine tests and review appointment.”

“As an example, by extracting and plotting my MDRD [modification of diet in renal disease] levels, I am able to see that although there is spot variance over the last few years within the band, the trend is not worsening and the CKD [chronic kidney disease] is still acceptably staged 3A. The trend, rather than a spot figure. Maybe an appropriate consideration in determining ongoing medications and I would be able to have an intelligent discussion of this with the GP a better understanding of his view and recommendations in the matter.”

“To discuss results.”

“Getting blood results for hospital appointments.”

“Not having to come in to pick up printed results to take to the hospital.”

HIFA profile: Richard Fitton is a retired family doctor - GP, British Medical Association. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data

Email address: richardpeterfitton7 AT gmail.com