Quest was supposed to test a whole panel of things, but they did not. The tech did not see that there were two test scripts. So I wasted a DR. appointment today and have to go back.
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... TSH 2.95mIU/L In Dec. it was 2.11 range 0.111-4.9 ...
STLEMIYC ( Stop the Lab Error Madness If You Can )
I caught such a mistake last week by checking the tubes and labels before the draw. Prior to my arrival I communicated with the lab manager about a pattern of errors. When I checked in I verified the orders. All that and they still erred. Checking your tubes and labels insures that at least the sample was drawn. I'd also recommend asking that extra tubes be drawn in case the test needs to be re-run or something else tested.
General tips for testing:
Before the draw:
Discuss with your MD the methodology. If appropriate, as in E2, ask that he specify methodology on the order.
Choosing between electronic orders or written ones:
A manually written order may by-pass insurance pre-authorization . CMS requires a ICD-10 diagnostic code which falls within their guidelines for coverage. Asking for both manual and electronic orders may trigger another problem: Some lab system computers will automatically void the electronic order if the MD prints it. The order is "released" (voided) the moment he prints them out. Even though you have a valid written order in hand the "released" flag may pop up when you check in for the draw.
More than one MD or multiple orders:
Can be a problem owing to a combination of antiquated computers, lousy software and misinformed personnel.
The DHS issued a final rule effective April 7 2014:
https://www.federalregister.gov/doc...-privacy-rule-patients-access-to-test-reports
Here DHS explains how this rule was a collaboration of the CDC the CMS and the OCR Office of Civil Rights:
https://www.hhs.gov/hipaa/for-professionals/special-topics/clia/index.html
Four year later we are still hearing:
"Those are the doctor's lab orders." "They belong to him." "Your other MD's needs to request the results from the ordering MD"
NO, no, no! Every one of your treating physicians are privy to all your lab results. Per HIPAA 1996 they always have been and without the need to first obtain a HIPAA release from you. The 2014 Final Rule simply extends right of access to you. Common sense and health care cost reduction dictate that a particular assay be run just once and the results shared. Neither the lab software nor the lab personnel and in most cases not even the MDs have adjusted to this reality.
Other:
In advance of the draw try contacting the lab manager or supervisor regarding on-going issues. Verify that all docs and yourself are to be resulted. The ordering MD can help by indicating who is to be resulted and their fax number as well as "result pt immediately".
A tech will enter the orders again at time of draw and print the tube labels. This is an opportunity to catch a mistake but you're not done. Show your list to the phlebotomist and ask her to verify that her tube labels, tube types and orders concur with your list even if you have done all of the above. As insane as it may seem I had verified yesterdays labs at check in after going back and forth with the lab manager for weeks to consolidate the orders. The lab data entry tech required well over an hour to re-enter the labs. She had compared her list against mine and assured me all was correct. - -Fortunately I asked the phlebotomist to go over it again. - - Tubes and labels were missing!!
