PDF(Pubmed)
Abstract：
The 21st Century Cures Act (Cures Act) information blocking regulations mandate timely patient access to their electronic health information. In most healthcare systems, this technically requires immediate electronic release of test results and clinical notes directly to patients. Patients could potentially be distressed by receiving upsetting results through an electronic portal rather than from a clinician. We present a case from 2018, several years prior to the implementation of the Cures Act. A patient was notified of fetal demise detected by ultrasound through her electronic health record (EHR) patient portal before her clinician received the result. We discuss the patient\'s ensuing complaint and healthcare system response. This unusual and dramatic case of fetal demise is relevant today because it underscores the importance of involving a patient and family advisory council in decision-making. It also highlights the value of \"anticipatory guidance\" as a routine clinical practice in this era of immediate access to test results.
摘要：
《21世纪治愈法》（《治愈法》）信息阻止法规要求患者及时访问其电子健康信息。在大多数医疗保健系统中，从技术上讲，这需要立即以电子方式将测试结果和临床记录直接发布给患者。患者可能会因为通过电子门户而不是临床医生接收令人沮丧的结果而感到沮丧。我们介绍了2018年的案例，即《治愈法》实施前几年。在临床医生收到结果之前，通过其电子健康记录（EHR）患者入口通知患者超声检测到胎儿死亡。我们将讨论患者随后的投诉和医疗保健系统的反应。这种不寻常且戏剧性的胎儿死亡案例在今天具有重要意义，因为它强调了让患者和家庭咨询委员会参与决策的重要性。它还强调了“预期指导”作为在这个立即获得测试结果的时代的常规临床实践的价值。
