RODALE NEWS, EMMAUS, PA—As it turns out, no news is not always good news. A new study shows that in one out of 14 abnormal test result cases, the patient was not informed of the irregular result. “You should not assume that no news is good news, even if the doctor’s office says, ‘If you don’t hear from us, it’s OK,’” says Lawrence Casalino, MD, chief of the division of outcomes and effectiveness research in the department of public health at Weill Cornell Medical College. “Even in the best-organized practice, things get lost,” he adds.
THE DETAILS: Dr. Casalino, who himself has 20 years of family physician experience under his belt, knows firsthand how easy it is for test results to fall through the cracks. In his study, just published in the Archives of Internal Medicine, he analyzed 5,434 patient records from 23 physician practices across the country. While some of the practices were nearly perfect, others failed to let patients know of abnormal results 25 percent of the time. For some patients, that failure could be the difference between life and death.
Nor should you assume that your doctor’s fancy-schmancy computer system means the office is on top of things. Researchers found that groups that stuck with simple paper-based processes to manage test results were less likely to forget to inform patients of abnormal results. Electronic records didn’t necessarily prove more successful, and offices using a mix of paper and electronic records had even higher failure-to-inform rates.
To avoid errors, the study authors suggest all test results be routed to the proper physician, who then must sign off on the results. The office should contact patients with the test results no matter what the outcome, and then should document that the patient was called. As a backup, patients should be told to call within a certain time period if they haven’t heard from the doctor’s office.
Published on: June 29, 2009