In early April, a federal rule took effect enabling patients to view their medical records without paying any fees and without waiting days or weeks. As a result, many patients will be able to find test results, clinical notes from their doctor and other medical information posted to their electronic portal as soon as they are available. While most physicians and patients view this as long overdue, a few obstacles have arisen. In some cases, test results can be made available to a patient before their physician has seen them. This can be a problem if further explanation or comments are appropriate. Doctors are also concerned about sensitive comments being seen by a parent of an adolescent who wants to keep the information confidential.
The AMA is pushing for modifications that would provide for brief delays when results involve a difficult diagnosis, such as cancer. Representatives of the Office of the National Coordinator for Health Information Technology, the federal agency overseeing the rule, have emphasized that patients can always decide whether they want to look at results or wait and review them with their doctor. Also, the rule does not require that parents be given access to protected health information if they did not already have that right under HIPAA. Some electronic health records enable doctors to withhold results, a step the doctor can discuss with their patient prior to ordering the test. While the overall response is positive, discussions will likely continue as patients become better informed about the tools available.