Over the years I have hosted about 30 seminars or seminar
series or workshops, and I will admit that I have be pleased with how about 25
of them have gone.
Yesterday I hosted my
19th seminar with the Canadian Association for Clinical Microbiology
and Infectious Diseases conference which is being held here is Vancouver, and
in all due respect to all the other sessions, this one ranks NUMBER 1 in terms
of Quality of Content, and overall Quality of Speakers. It was the perfect blend of new information,
controversy, and future visioning. I have long since stopped worrying about
numbers of attendees. The people that
came all enjoyed the discussion and information.
The themes covered included Pre-examination issues in
laboratory testing, with some particular reference to Microbiology (it is a
part of a microbiology conference), reported laboratory errors, with particular
reference to breaches in confidentiality and a special focus on
Post-examination reporting of laboratory reports.
All the content was excellent and well delivered, but
from my personal perspective, the number 1 presentation was the one by Krystyna
Hommen on reporting of results directly to patients. Ms. Hommen is the President and CEO of a
company in this province that provides the electronic service that transmits
over 8 million medical laboratory reports to hospitals, physicians and patients
every year. That, by my estimate, would
likely make her company the largest purveyor of medical information in this
province, but would likely rank her in the top 3 in Canada and I would guess
the top 25 in North America.
Starting in 2010 under a program called eHealth, her
company started to provide information in a structure that allows patients to
access their own medical laboratory information. Now, barely 2 years later, the uptake of
people participating is near 220,000.
What is stunning about that number is that the total population of
British Columbia is about 4 million, of which about probably 2 million would be
in the age range of 16-80. That means
that over 10 percent of people are taking advantage of the system. Her experience is that the rate of new
registrations is near 400 a day which means that by this time next year the
people taking advantage of accessing their own information will be near
400,000. Even at that rate, one can
extrapolate that within 5 years near 100 percent of the adult population of
this province will have direct access.
To put that number in other perspective, BC has about
6000 physicians which means that today personal access overwhelms physician
access by near 4:1. By this time next
year it will be much closer to 8:1.
What is so important is that people don’t just gather
their information; they go back again and again, studying their information. They are becoming better self-informed. As Ms. Hommen points to, as they review their
results, they are becoming more engaged in their own health issues. And they are picking up errors such as lost
or missing information. So it is fair to
say that eHealth is contributing directly to laboratory quality improvement
when the report these problems.
It was interesting that the questions from the audience
picked up many of the issues that I have mentioned previously on MMLQR. How do people respond to corrected
reports? How do people protect their
information from others, including those from previous personal
relationships? Who has access to information
for children? All these were addressed.
Ms. Hommen pointed out that while her company is a leader
in this field, several other provinces are coming on board with similar
services. Likely by 2020 this will be
the way in which laboratory information is transmitted.
This is truly the dawn of a new and exciting era of
personal ownership and engagement in personal health. If the laboratory wants to remain a healthy
and relevant part of the equation, there is a lot of work to be done. The format and structure of reported
information has to improve. The quality
and reliability of the information will have to become much, much better. The jargon will have to go and be replaced by
new and better informative content. And
laboratories are going to have to learn to take a whole lot more responsibility
of the quality of their samples, in particular the impacts of collection and transport
errors.
As pointed out before, in Canada the route to
satisfaction for medical error is suit.
In Canada we talk about malpractice suing, but we don’t really do it all
that much. As people become more engaged, the level of
interest in how errors affect health decisions will become greater and
greater. Our patients’ patience will
meet its limits. And as a fellow on the
television (Kevin O’Leary) says, the result will be that folks will sue
laboratories into the Stone Age.
For reference, the presentations are available at
www.POLQM.ca
