REPORTS OF LABORATORY FINDINGS TO PATIENTS-UPDATE

January 10, 2008		2008-R-0046
Reports of Laboratory Findings to Patients-Update

By: John Kasprak, Senior Attorney

You asked if laboratory test findings can be reported directly to a patient and if not, why isn’t this allowed.

SUMMARY

State law does not allow the direct reporting to patients of laboratory findings. But they may be reported to patients upon the written request of the providers who ordered the testing. Generally, this prohibition is designed to protect the patient by insuring that proper explanation and interpretation of laboratory findings are given, and possible harmful misinterpretations avoided. (This report updates OLR Report 99-R-0447).

STATE LAW ON LABORATORY REPORTS

By state law, a “provider” must provide a patient, upon request, complete and current information possessed by that provider concerning any diagnosis or treatment (CGS § 20-7c(b)). Upon the written request of the patient, his attorney, or his authorized representative, a provider must give the person a copy of the patient’s health record including bills, x-rays, and copies of laboratory reports (CGS § 20-7c(c)).

For purposes of this requirement, state law defines “provider” as any person or organization licensed or certified to furnish health care services. This covers physicians, chiropractors, naturopaths, podiatrists, athletic trainers, physical therapists, occupational therapists, alcohol and drug counselors, radiographers and radiological technologists, midwives, nurses and nurse’s aides, dentists and dental hygienists, optometrists, opticians, respiratory care practitioners, perfusionists, pharmacists, psychologists, marital and family therapists, clinical social workers, professional counselors, veterinarians, massage therapists, electrologists, hearing aid dealers, speech pathologists and audiologists, and emergency medical service providers (CGS § 20-7b(a)). Laboratories are not included in this statutory list.

The law allows a provider to withhold such information from the patient if he reasonably determines that the information would be detrimental to the physical or mental health of the patient, or likely to cause the patient to harm himself or another (CGS § 20-7c(d)).

Additionally, Department of Public Health (DPH) regulations specifically provide that “Laboratory findings on a specimen shall be reported directly to the licensed provider who ordered the testing…and may be provided by laboratories other than the department’s laboratory to lay persons upon the written request of the provider who ordered the testing” (DPH Regs. § 19a-36-D32).

RATIONALE

The basic reason that state law does not allow reporting of laboratory findings directly to the patient is concern for proper interpretation and use of the findings. The laboratory report may include raw data that a layperson would first have to be able to interpret and second, place in some health care context. While some laboratory reports may be simple and easy to understand (e.g., cholesterol screenings), others require the involvement of a physician or other provider for interpretation and explanation of the laboratory findings and consideration of future treatment or testing. Avoiding misinterpretation of laboratory findings is an important consideration.

LEGISLATIVE CONSIDERATION OF THE ISSUE

The Public Health Committee has been aware of this issue and discussed it in the past. But, it appears no specific proposal on this issue has been made recently.

PA 98-144, which is somewhat relevant, requires licensed health care institutions to provide a patient (or his designated health care provider) reasonable opportunity to examine tissue slides and pathology tissue blocks they retain (CGS § 19a-490b(a)).

Upon the written request of the patient, his attorney, or designated health care provider, the institution must send the original retained tissue slide or block directly to the patient’s designated licensed institution, laboratory, or provider. If an original slide or block is not available or a new section cut of the original fairly represents it, the institution may send a new section cut, clearly labeled as such, to the person’s designated provider. The law in this case defines “health care providers” as physicians, institutions, and labs licensed in the state where they are located. Licensed health care institutions include hospitals, nursing homes, rest homes, and home health care agencies.

Under the act, recipients of the slide, block, or new section are solely responsible for safeguarding and returning it to the institution. The act absolves from liability institutions or laboratories that release or fail to retain slides, blocks, or new sections and provides that no action for damages may be brought against them.

JK:ts