Radiology groups who provide imaging services to patients in Pennsylvania should be aware of a new state law known as the “Patient Test Result Information Act,” or Pennsylvania Act 112 of 2018. Originally scheduled to begin on December 23, 2018, its implementation has been delayed for a year. In order to implement compliance with this new law, radiology groups and the facilities in which they practice will have to develop a system to monitor results and identify those that require a notice to be sent.
This act provides that the patient must be directly notified within 20 days when a diagnostic imaging exam is performed that identifies a “significant abnormality” may exist. The law defines a significant abnormality as one that “would cause a reasonably prudent person to seek additional or follow-up medical care within three months.” It is important to note that this notice to the patient is in addition to the normal reporting of results to the ordering physician.
The text of the law requires that “the entity performing a diagnostic imaging service” is responsible for giving this notice to the patient. A freestanding imaging center would normally take care of this task for the radiology group practicing in the facility, and in the hospital outpatient setting it is generally recognized that the hospital would be the entity responsible. However, radiology groups would be wise to ascertain that a system has been implemented in any setting where they interpret patient exams that are performed in Pennsylvania, regardless of where the interpretation services may take place.
A separate notice does not have to be sent if the patient was told of the result at the time of the visit or if the patient was given a copy of the report during the visit. Best practice would be to obtain a confirming signature in either of these cases to document that the patient was notified. The requirement to notify the patient also does not apply to:
- Routine obstetrical ultrasound exams
- Plain x-rays
- Emergency Department imaging services
- Inpatient imaging services
The notice to the patient has to contain certain specific information, as follows:
- The name of the ordering physician.
- The date the imaging service was performed.
- The date the results were sent to the ordering physician.
- The following statement: “You are receiving this notice as a result of a determination by your diagnostic imaging service that further discussions of your test results are warranted and would be beneficial to you. The complete results of your test or tests have been or will be sent to the health care practitioner that ordered the test or tests. It is recommended that you contact your health care practitioner to discuss your results as soon as possible.”
- The contact information necessary for the patient to obtain a full report.
The notice may be delivered to the patient using any one of the following methods, as long as it is acceptable by the patient:
- US Postal Service mail
- “Automatic Alert” from the practice’s EHR that a notice has been posted to the patient’s electronic health record
- Directly to the patient at the time of service, so long as the patient acknowledges the receipt of the results and signs the medical record.
While sanctions by the PA Department of Health for noncompliance will not be in effect for another year, we recommend that practices begin the process of developing and implementing a system as soon as possible. Sharon Taylor, HAP’s Chief Clinical Informatics Officer, suggests that some practice systems can be adapted to this purpose by creating a specific identifier during dictation that will allow the radiologist to flag the exam for the proper notice to be sent. The system should be able to provide documentation so the radiology facility will be able to satisfy any subsequent audit by the Department of Health. HAP clients should meet with their client manager to discuss their options.
We will continue to monitor and report any developments related to this Pennsylvania law. Our team regularly monitors legislative activity across the country, and we strive to keep you as informed as possible. Be sure you are subscribed to this blog to receive timely updates.