Thursday, October 4, 2007

Results Managemenent, Critical results reporting

Clinical test reporting is a big issue for physicians. As a physician based in an ambulatory office, I may have several patients at any given time undergoing various radiology tests such as a chest x-rays or CT scans. When the results are normal, it's okay to receive the results by routine fax or ground mail. Potential problems however occur when there's an abnormal result that needs follow-up.

Although many times these critical results are also faxed to the doctor, this really is not an acceptable way of communicating a result needing follow-up. Faxes are notoriously problematic. You can never be sure that the recipient has received the faxed document. After all, fax machines can run out of paper or ink and there is no way for the sender to know that the recipient has received the document.

There needs to be proper follow-up on abnormal test results. By this I mean the radiologist making the abnormal finding should really be calling the ordering physician to review these abnormal findings and to develop a follow-up plan. When results are very high in critical severity, this process usually occurs. When the results may not rank high in the severity scale but are still abnormal, a one-to-one notification method still needs to be in place. There needs to be a system to verify that the abnormal result was received by the appropriate party. An electronic system would be ideal.

If an abnormal result has not been receieved by the appropriate provider, another attempt must take place to convey the results. If all attempts fail, there needs to be further escalation of the process to ensure that a responsible physician is able to act on the abnormal results.

I came across a possible vendor solution to this problem:

"Critical test reporting, closing the loop"

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