Support for RACGP warning on immediate pathology results

A Federal Government plan to remove the seven-day delay for all pathology and diagnostic imaging reports on My Health Record could lead to unintended negative consequences, the Royal College of Pathologists of Australasia (RCPA) has said.
 
The fresh warning, issued in a joint statement with the RACGP, points out that the current system helps patients understand and interpret results in a safe and caring setting, with RCPA President Associate Professor Trishe Leong saying they should review results with their doctor.
 
‘The RCPA believes that patients should be fully engaged in managing their care, and access to diagnostic information is part of that management,’ she said.
 
‘We therefore support the sharing of information without barriers to access, such as the seven-day rule, overall.
 
‘However, it is critical that if these delays are removed, consumers are advised to review their results with their GP or other specialist and are also provided with evidence-based information on pathology testing such as Pathology Tests Explained, and contact details for general support services, such as GPs and Lifeline.’
 
Currently, patients must wait seven days before they can access most pathology and diagnostic imaging reports that have been shared to My Health Record, which RACGP President Dr Nicole Higgins said allows healthcare providers time to review and schedule appropriate follow up with their patients.
 
‘We strongly support patients having access to their results and medical history,’ she said.
 
‘GPs and other specialists don’t seek to be medical gatekeepers, but we are there to support our patients to understand their results, treatment options and next steps.
 
‘Much of the terminology entered into My Health Record, is written for doctors, by doctors, and has to be understood in the context of a patient’s medical history and other health factors and conditions.
 
‘[While] patients often get good insights and find support by looking into their results … it’s important they know what their results mean for them. That’s the value of having a usual GP.’
 
Dr Higgins also pointed out that pathology results can be stressful, which means there is ‘real value’ in having a two-way discussion with a trusted medical professional.
 
‘There is also a worrying amount of vague, unapplicable, and outrightly incorrect information online. Patients who have worked with a doctor to understand their health are better supported to know what information applies to them, and what doesn’t,’ she 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.’
 
Both colleges have recommended that some diagnostic tests be considered for exclusion if the seven-day rule is removed. This includes anatomical pathology and cytopathology reports, which are often discussed at multidisciplinary team meetings to determine an appropriate clinical path, and genetic test results which often carry broader, more long-term, and more complex implications than other pathology results.
 
‘Anatomical pathology and cytopathology reports can be very complex, and consideration is required as to whether their immediate release is in the consumers’ best interest,’ Associate Professor Leong said.
 
‘Genetic test results are often probabilistic, have consequences for family members, have potential psychological impacts, can have unanticipated implications, and vary in their actionability and therapeutic options.
 
‘Post-test counselling is therefore considered crucial to prevent potential patient harm from specific genetic tests and results.’
 
Both the RCPA and RACGP have said broad consultation is required on any exceptions made to the seven-day rule and requested they be part of those consultations with Government to ensure appropriate oversight.
 
‘Pathologists and requesting doctors are best placed to determine when specific genetic tests or results require post-test counselling,’ Associate Professor Leong said.
 
‘To allow for such counselling, providers should have the discretion to delay releasing results for up to seven days when clinically warranted.
 
‘We must consider the unintended consequences of a patient failing to return for a clinical appointment because results are within the normal range or misinterpreted. This significantly impacts patient care and requires a system for monitoring.
 
‘Similarly, the impact on healthcare providers needs to be considered, with increased communication from patients to the referring healthcare providers or directly to the laboratories, wanting to know the meaning of an unexpected abnormal result.’
 
The initial round of consultation in relation to removing the seven-day rule concluded in October 2023, and the Government has indicated that it will implement the change later this year.
 
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