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A health group with 150,000 patients has pulled out of a system that shares lab test results among doctors because of fears over inadequate informed consent.
The withdrawal of North Shore-based Harbour Health and most of its GPs is a blow to the Auckland region's TestSafe system of sharing lab results among district health board clinicians and participating GPs.
TestSafe was started without fanfare by the region's three boards in 2006 as a way to reduce duplication of lab tests done or funded by the DHBs and to improve patient safety by making the latest results instantly and widely available.
Patients can opt out test by test. In the first nine months, just 18 did so, out of more than 560,000 tested.
Yesterday, however, the Herald learned that all but three of the 147 GPs in the Harbour Health primary health organisation told TestSafe in July not to list their patients' results.
Chief executive Susan Turner said they had done so because of legal advice that it was impossible for GPs to obtain informed consent from patients to have their results put on to the TestSafe database.
This was because GPs were unable to specify who would have access to the test results.
"When a doctor goes through an informed consent process they have to be able to say what's happening to that information," Ms Turner said. The current process left GPs at risk of accusations they were breaching patients' rights.
"When we talk to patients about this they are horrified that their information is stored like that."
Ms Turner said the DHBs had indicated they wanted to introduce systems like TestSafe for DHB-funded medicines and for all "clinical events" - in effect a comprehensive electronic health record.
Harbour Health supported electronic health records if they were set up properly and the organisation was negotiating with the DHBs over TestSafe, Ms Turner said.
A spokeswoman for the Auckland District Health Board said DHBs met Harbour Health in early August and followed that up with correspondence "clarifying their response to issues raised by Harbour Health".
"The DHBs have heard nothing further and are actively pursuing avenues for resolving Harbour Health's concerns," the spokeswoman said.
She noted TestSafe was designed to ensure that all relevant diagnostic results were available to clinicians treating patients.
However, North Shore Hospital haematologist Dr David Simpson said he had seen four Harbour Health patients in the past fortnight who had reported having had blood tests, but when he looked on TestSafe he could not find them.
He could ring Diagnostic Medlab for results, but because patients did not always report their full medical history to doctors, absence of results from TestSafe opened the way to potentially fatal medical mistakes.
What is TestSafe?
A database of patients' lab-test results run by Auckland's three district health boards and based at Middlemore Hospital.
Gives all DHB clinicians and participating GPs online access to all patients' listed DHB-funded test results.
Use is audited to check that clinicians are viewing only the records of those under their care.
Patients can have the opt-off box ticked on the test order form or phone TestSafe (0800-522-7232) to ask that a test result not be entered.
Supporters say TestSafe reduces duplication of tests and increases safety, especially in emergencies, by giving clinicians instant access to the latest results.
Detractors say it threatens patients' privacy, especially for sexual, mental and other sensitive health matters, and puts doctors at risk over informed consent.
