Patient Test Result Information Act

PENNSYLVANIA REQUIRES DIRECT NOTIFICATION TO THE PATIENT OF ABNORMAL RADIOLOGIC FINDINGS

On October 24, 2018, the “Patient Test Result Information Act” was enacted into law in Pennsylvania.  This law requires imaging facilities that perform tests such as CT scans, MRI exams, PET scans, and ultrasound tests to directly communicate “significant abnormalities” to patients.  The law defines a “significant abnormality” as follows:

“A finding by a diagnostic imaging service of an abnormality or anomaly which would cause a reasonably prudent person to seek additional or follow-up medical care within three months.”

Imaging facilities continue to be required to also notify any abnormal findings to the physician who ordered the test.  Nonetheless, the drastic increase in “out-patient imaging centers,” combined with frequent failures to appropriately communicate abnormal findings to ordering physicians and patients, prompted the enactment of this law.  The “Patient Test Result Information Act” became effective on December 23, 2018.

This law significantly impacts how a patient is notified of a significantly abnormal imaging finding.  Previously, after an imaging study was ordered by a physician, the test would be performed and a radiologist would interpret the images and prepare a Report detailing the relevant “Findings” and “Impressions.”  The Report would then be forwarded to the ordering physician, who would communicate the findings to the patient and discuss treatment alternatives.  Unfortunately, breakdowns in this chain of communication had the effect of delaying a patient’s needed and sometimes emergent medical care.  The “Patient Test Result Information Act” is designed to eliminate these communication errors by requiring imaging facilities to directly inform patients of significantly abnormal radiologic imaging study results.

In the past, radiologists and imaging facilities were often considered “consultants” who rarely interacted with patients and were only required to report their findings to the ordering physicians on a routine basis.  However, in those situations where imaging findings suggest a need for urgent treatment, the interpreting radiologist was nonetheless duty-bound to rapidly notify the ordering physician of the abnormal findings, either by telephone or in person.  Specifically, guidelines established by the American College of Radiology in 2014 require an interpreting radiologist to rapidly communicate abnormal findings to the ordering physician in the following situations:

• If the abnormal finding requires immediate intervention. Examples include air or blood in the chest cavity, air or blood in the abdomen, improperly placed catheter lines, feeding tubes and/or breathing tubes;
• An abnormal finding that disagrees with a prior interpretation of the same study where the failure to act quickly could be detrimental to the patient’s health;
• Abnormal findings that do not necessarily require immediate attention, but may worsen over time if left untreated. Examples include tumors that could be cancerous and other acute infectious processes.