Patient-oriented pathology reporting –
time to move it forward

The long-touted removal of the seven-day delay for patients to be able to access pathology results through My Health Record has finally occurred – with the exceptions of histopathology, cytopathology and genetic pathology tests, for which there will be a five-day delay. There have been some valid arguments against this change, including from the AMA and the Royal College of Pathologists of Australasia.

Whilst it is right that patients can access their own health information, the framing and contextualisation of results on their first presentation to the patient is generally best done by the treating doctor or clinical team. A numeric (such as a plasma concentration or cell count) or text-based (e.g. cytopathology or histopathology) report will rarely be accurately interpretable by the patient in isolation from the clinical information known by the requesting doctor.

As we all know, a result within a “normal range” does not necessarily mean there is no physiological abnormality; and a result outside that range does not necessarily indicate disease.

Nonetheless, the change has occurred; and now patients can access their pathology results in real time. The sky will not fall in, but our profession does need to consider its implications. And those of us in the specialty of pathology must think about how it affects our relationships and responsibilities with patients and clinicians.

Like all doctors, our primary responsibility has always been to patients. But unlike our clinical colleagues, most of our communication on a day-to-day basis is with our requesting doctors, rather than our patients. This will not change.

However, we now know that our patients are receiving our reports at the same time as their requesting doctors, and we know that our reports have the potential to mislead or even cause harm if read out of context. Therefore, we should consider whether there has been a change in our responsibilities.

Therefore, we should seriously consider whether a more patient-oriented style of reporting is required. This would entail patient-oriented information in a pathology report that is additional to, rather than substituting, our existing clinically oriented interpretation.