December 2, 2005

Some lab results now available online

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My Health at Vanderbilt user and Adult Primary Care Center patient Gayle Gilmer reviews information from her medical chart at home.

Some lab results now available online

It's like online banking for patients, except instead of financial transactions, clinical lab test reports and radiology reports can be reviewed with the click of mouse.

My Health at Vanderbilt, the secure patient Web site launched two years ago, now includes most of the clinical test results and radiology reports that appear in the Vanderbilt electronic patient record (

Web links are included to help patients understand their test results and manage their health. This new version of the site was released Nov. 9.

Expansion of the site was based in part on ongoing discussions with about 40 patients who helped contribute ideas and feedback. Approval for the expansion came from the Medical Center Medical Board and Clinical Enterprise Group.

“With this latest release, My Health at Vanderbilt is now among a small number of the best Web sites in the nation for supporting communication between the patient and the health care team in the doctor's office,” said Jim Jirjis, M.D., assistant chief medical officer for electronic medical records, director of the Adult Primary Care Center and chair of My Health at Vanderbilt. “The site has great potential for helping us guide patients to effective self-care. It's the type of innovative support for quality outcomes that I believe distinguishes Vanderbilt from other health care competitors.”

Some clinical test reports appear on the site immediately, others are delayed for seven days and some reports, such as HIV, cancer pathology and drug screens, are not currently included on the site. Radiology reports are delayed for 14 days.

The Web site allows users to request Vanderbilt clinic appointments, view upcoming appointments, view doctor and hospital bills, pay bills and send questions to the billing department.

“Many patients have generously helped us test and improve the site and conceive new features to provide value for users,” said Sue Muse, project coordinator with Adult Primary Care and project director for My Health at Vanderbilt.

Improvements include:

• When patients click on the name of a lab test in My Health at Vanderbilt, an explanation appears about how the test is used and what the results mean.

• When the patient clicks on a lab result a graph of past results and notation of the range for normal results appear, just like the medical record application that Vanderbilt doctors use.

• Links to preventive health information appear automatically based on the user's age and gender. If the user has a diagnosis of diabetes (and if Vanderbilt has generated billing codes associated with this diagnosis), then the user will automatically receive links to information about diabetes. More automatic links concerning diseases and conditions will be added to the site soon.

The site also includes brief articles written at Vanderbilt about topical health matters like influenza and Vioxx.

Patients can register online for first-level access to the site, which includes the ability to make clinic appointments, view appointments and ask questions about bills.

Patients receive full access to the site with a photo ID and in-person registration at Guest Services in room 1801 of the Vanderbilt Clinic. Registration for full access will eventually move out to the clinics.

Secure two-way messaging is the single feature of the site that will perhaps be of greatest use. Messaging runs directly to and from a Vanderbilt medical records application called StarPanel.

“Providers and staff don't have to go back and forth between e-mail and StarPanel — it's all in one location,” Jirjis said. “Messaging through StarPanel also allows for automatic documentation of the patient's message in the chart without going through cut-and-paste contortions. It is safer care, because information is no longer stored in somebody's e-mail inbox where nobody else can get to it, but in the patient's chart where it belongs.”

As with patient phone calls, messages from patients don't go directly to doctors but are instead taken by clinic desk staff or by secretaries — that is, by whoever has been designated for this role by the clinician or practice group.

Messaging will roll out across Vanderbilt Medical Group over the next 12 months, Muse said. Messaging is currently in use in Adult Primary Care, Adult Nutrition, Hillsboro Medical Group and the VMG Green Hills Clinic.

Children and their parents will eventually have access to My Health at Vanderbilt, but for the time being the site is for adult patients only.

Adult patients soon will be able to grant third parties access to their records in My Health at Vanderbilt, and the health care team will be able to grant access to family members on behalf of patients who become unable to participate in health care decision-making.

The links with information about lab testing, preventive care and diseases were embedded by information specialists at Eskind Biomedical Library in consultation with Vanderbilt clinicians. This is part of Eskind's longstanding evidence-based medicine effort, initiated by Nunzia Giuse, M.D., M.L.S., professor of Biomedical Informatics and Medicine and director of the library. The project also aligns with Eskind's broader initiative to integrate library resources into the work of Vanderbilt clinical teams.