June 11, 2015

My Health moving to all-inclusive test reporting

Earlier this year the Medical Center Medical Board at Vanderbilt approved all-inclusive online reporting of adult patient test results through the Vanderbilt University Medical Center secure patient Web portal, My Health at Vanderbilt (MHAV).

Earlier this year the Medical Center Medical Board at Vanderbilt approved all-inclusive online reporting of adult patient test results through the Vanderbilt University Medical Center secure patient Web portal, My Health at Vanderbilt (MHAV).

The switch to fully comprehensive reporting will occur in early July and will be retroactive.
Nine years ago when VUMC prepared to launch MHAV, doctors considered which parts of the medical record Vanderbilt patients should be invited to view online. Patient portals that included any access to medical records were new.

“It was considered a somewhat risky innovation, but in the end the risk was outweighed by the new possibilities for patient engagement with medical care that might come with secure online reporting,” said Trent Rosenbloom, M.D., MPH, associate professor of Biomedical Informatics, Medicine and Pediatrics, who directs MHAV.

Under a three-tier approach initially adopted in 2006, results for routine tests are reported immediately in MHAV, while reporting of less straightforward test results is delayed three days. This delay allows the health care team a chance to review the results and provide them in their context to the patient. Some test results that are considered sensitive (e.g. HIV testing) are suppressed altogether in MHAV.

Health policy has changed in the years since MHAV was introduced. Some patient portals have begun offering secure online access to increasingly large amounts of the medical record.

Providers are giving more attention to supporting coordination across different care settings, and as information technology makes inroads into medicine, greater transparency of medical record information is increasing.

With the upcoming switch to fully comprehensive test reporting, MHAV is revising its three reporting tiers.

• When ordered for adult patients, results for approximately 2,000 tests formerly suppressed in MHAV will be reported after a delay of seven business days. Examples include results from CA-125 and CD4 testing. (Results for these tests will continue to be suppressed when ordered for patients age 17 and younger.)

• A delay of three business days will remain in place for results of some 3,600 other tests. Examples include aldosterone, group B strep antigen and antinuclear antigen testing.

• Approximately 555 other tests that are considered more routine will continue to be reported immediately. Examples include complete blood counts, cholesterol and basic metabolic panel testing.

“The delays for many MHAV test results is designed to allow our providers time to review the results and communicate with patients and families before the results are reported on the portal,” said Titus Daniels, M.D., MPH, MMHC, associate professor of Medicine, executive director of Vanderbilt Medical Group and chief operating officer for Adult Clinical Operations.

“Patients have always had full access to their medical records. Electronic Medical Records have allowed us to make patients’ information more easily retrievable for them, which is highly valued by patients. Comprehensive reporting of test results supports patient engagement and allows patients to be better informed, while also allowing them to share and discuss test results with other providers.” Daniels added.

According to Rosenbloom, VUMC began to reconsider suppression of MHAV test results early last year when the federal government issued a rule that providers must give patients and their representatives the ability to review test results electronically within 30 days of a request.

In addition to test results, MHAV also gives patients secure health team messaging, vaccine records and consumer health information.

Patients can also use the portal to request clinic appointments, complete clinic intake forms and pay bills. For more information visit MHAV here.