PWNHealth Physician Oversight

PWNHealth Physician Oversight

While employers can opt to provide their own medical oversight, Quest Diagnostics works with PWNHealth as the standard provider who oversees lab test ordering, results review, and critical alert calls. The PWNHealth network consists of more than 200 board-certified physicians who reside and practice in the United States.

How does physician oversight work?

PWNHealth ensures that an in-state physician oversees the lab test requisitioning, results review, and alerting of patients regarding any critical results. This is accomplished via a secure, Internet-based, HL7 data transfer interface and connectivity platform that is HIPAA-compliant. PWNHealth also provides compliance. This comprehensive approach to physician oversight, provided in partnership with PWNHealth and their physician network, set the standard relative to health screenings in the employer channel and further provides an auditable “closed loop” data flow for compliance.

The physician oversight process

  • Physician reviews the screening request and orders the lab tests  If a participant has a critical (life-threatening) value, a physician calls the participant as soon as the results are available
  • If a participant has an alert value (an elevated result but not critical), a physician calls the participant the day after the results are available
  • The PWNHealth physician will make 3 attempts to reach the participant by phone
  • If the participant is unable to be reached via phone, he/she will receive a letter from PWNHealth regarding the alert value

Frequently Asked Questions

1. How does PWNHealth work with Quest Diagnostics?

PWNHealth’s nationwide physician network authorizes the lab testing process via protocols. The physicians review the requests, order the tests, review the results and oversee outbound communications to all participants with abnormal and critical results.

2. How does PWNHealth handle participant outreach for abnormal and critical results?

PWNHealth staff, acting under the guidance of the ordering physicians, makes all phone calls and sends all letters that are necessary for abnormal and critical values. In the event that a client wishes to have its medical staff handle this outreach service on its own, PWNHealth will work with the client to provide appropriate direction so that it can adhere to PWNHealth standards on participant outreach and provide PWNHealth with the appropriate documentation to confirm compliance.

3. Who sets the alert and critical values?

PWNHealth uses the critical values established by Quest Diagnostics for participant contact. These values have been reviewed and approved by the PWNHealth Medical Director, the medical advisory board, and the physician network. PWNHealth provides Quest Diagnostics with alert lab result values that, based on their Practice of Medicine guidelines, trigger participant follow-up contact. Quest Diagnostics has reviewed, accepted and published these alert triggers under contract guidelines with PWNHealth.

4. How quickly are calls made to participants?

Protocols drive the outreach process. If a lab test result is critical (e.g., life threatening), PWNHealth receives a call from Quest Diagnostics as soon as the result is available, and then PWNHealth calls the participant, regardless of the time of day. If a lab test result is NOT critical, but is an “alert” level abnormal result, (e.g., non life-threatening),the participant is called the next business day during normal business hours.

5. How many times does PWNHealth try to contact the participant?

PWNHealth staff will make six attempts, one per day, to contact a participant. After the sixth attempt, PWNHealth will mail a certified letter to the participant notifying them that they have alert level abnormal results and advising them to follow up with their primary care physician.

6. What is the context of the conversation between PWNHealth and the participant?

The PWNHealth staff member identifies him or herself as a representative at PWNHealth, calling to alert the participant of an urgent lab test result from their recent employer-sponsored Quest Diagnostics biometric screening. The representative asks the participant if they would like to review the lab results from their recent blood draw. The PWNHealth representative then verifies the participant’s name and date of birth to validate their identity. PWNHealth conveys the results that are out of range and provides them the normal value ranges for context. The PWNHealth representative strongly advises the participant to take their results to their primary care physician for follow-up. PWNHealth does not diagnose or treat over the phone, nor do they discuss what an out-of-range value could mean.

7. May results be sent to a participant’s personal physician?

Yes. With a participant’s consent and PWNHealth’s physician’s authorization, Quest Diagnostics will fax the results to the physician identified by the participant. The participant would call the Quest Diagnostics Service Center and request a copy of their results. The participant would then complete a form indicating this request, and the Quest Diagnostics Data Team would manage the reporting to the primary care physician.

For more information on physician oversight, contact your Quest Diagnostics Sales Representative or email PopulationHealth@QuestDiagnostics.com

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