Communication & Tracking of Lab Results - A Modern Approach

Proper tracking and communication of test results is no longer an option for offices – it is a requirement. No other segment of society responsible for health and wellness is as slow to embrace information technology. SecuReach Systems provides a solution.

The Institute of Medicine in their report The Chasm of Quality in 2003, found that medical errors are responsible for 98,000 deaths a year. Researchers have found that although the ultimate error is generally a mistake in treatment or diagnosis, fully 55% of these errors are set in motion by informational or personal miscommunication. The end result of these errors is found in these typical malpractice cases:

• Florida – woman not informed of an abnormal mammogram – 10 months later develops metastatic breast cancer – jury award $6.8 million.
• Washington – woman not advised of elevated clotting studies while on blood thinner – has stroke resulting in permanent brain damage – jury awards 2.2 million against doctor and $750,000 against hospital.
• New Hampshire – office loses a positive antibody screen for routine pregnancy – stillborn baby results – case settled for undisclosed amount .

T he National Practitioner Data Bank – Public Use File – September 30, 2007 shows that most common Diagnosis Related Claim is Failure to Diagnose. A majority of these claims are tracking and communication errors in which tests are either not completed, lost, or not communicated to the patient in a timely manner. These often result in large payouts but the real tragedy is a missed or late diagnosis and/or treatment. The human cost cannot be measured – and is completely preventable with a well thought out patient communication and tracking system.

Everyone can agree that No News Is Good News is a liability nightmare when talking about communicating test results to patients. But there is a reason that most offices still use this dated and dangerous method. If you are going to improve patient safety and reduce malpractice risk you must be sure that:

• Every test (including normals) is communicated to patients.
• The need for follow up is stressed.
• Non-compliance is addressed.
• Everything is documented.

This is where risk managers (and articles like this) usually end. They do not offer solutions that are time and cost effective and easy to learn and use. The end result is that after starting with good intentions, inevitably the system is abandoned. This article will show you a better way that can actually work.

Patient tracking and communication can be accomplished three different ways.

• Paper tracking and calling patients manually – This is the time honored method that is generally recommended by specialty organizations and risk managers. Tests are entered into ledgers or tickler files; crossed off when the result returns; and then periodically checked to see what tests have not been completed. At that time the patient is reminded (by phone or mail) that the test has not been completed and encouraged to do so. Test results are called to patients, sometimes by the physician but usually by the ancillary staff when they have time.

 This method is time consuming, fraught with error and is nearly impossible to implement without hiring more staff. In an era where medical reimbursements continue to drop while expenses have skyrocketed, this simply is impossible to do and should not be considered.  

• Paper tracking and automated calling systems – This addresses the fact that for health protected information, it takes multiple calls per test result to contact a patient since you cannot leave the results on regular answering machines. A variety of commercial calling systems are available which can save time on contacting patients with results. The best of these systems can free up enough staff time to do the manual tracking portion. Items to be considered are: cost; ease of dictation; are patients notified when results are in; and how is reporting done when messages are not received (real-time or periodic reports).
• Automated tracking and calling systems – SecuReach Systems is a unique web-based application which combines an automated tracking system with a unique calling system which allows you to send test results, reminders and messages to patients – without ever using the telephone. Consider what you should do for the perfect system for tracking and communication: 

• Enter all tests, referrals and follow ups.
• Send email and voice messages to remind patients of tests which need to be done.
• Record test result messages – preferably in the physicians own words.
• Notify patients that test results are in.
• Send reminders when tests are not completed.
• Track all tests, referrals and follow ups and leave a daily alert for all staff members and MD’s for tests not completed and messages not received.
• Record and save all correspondence including voice message files in case of legal issues.
• Work nights and weekends – never take vacation or time off! Tracking is that important!

This seems like a great deal of work until you realize that SecuReach automates every step automatically except for a) and c) which is in bold lettering. An office is left with doing exactly what they already do in an office – ordering tests and sending results out to patients! SecuReach does this for a clinician for under 5 dollars a day. Office efficiency and time saved more than pay for such a system.

Founded in March 2005, by Steven M. Pap MD with 27 years of medical practice experience, SecuReach Systems, Inc., Medina, Ohio is a provider of private voicemail solutions servicing physicians, staff and patients. It addresses an important need in the medical community - the staggering amount of tests ordered by physicians which must be delivered to the patients in a time saving, user friendly and cost effective way. SecuReach serves as a malpractice risk reduction system for physicians by tracking every medical test or referral from the time it is ordered until the patient actually receives the result. An intricate system of automatic reminders, emails, and daily alerts accomplishes this. More importantly, SecuReach serves as a patient advocate - ensuring patient safety by improving communication of abnormal tests and instructions. Our tag line is our mission – Saving Lives by Improving Patient Communication.

The SecuReach Solution – SecuReach delivers this solution (patent application in process) as a web-based ASP (Application Service Provider). The only requirement for physicians and their office staff is a broadband Internet connection. There is no expensive software or hardware to buy. The medical office is provided a user name and password to access the system. The basic system works as follows: Each patient is provided with a custom patient card (credit card quality) with a unique box number and pin number. When a test returns to the office, the physician or designated staff member dictates the actual results into the application via a USB port microphone. The recording applet uploads the file into the SecuReach database. At this time, the system calls the patient with a generic message which states that a result has been dictated into the patient’s private voicemail box. When the patient receives this message, he or she simply calls the toll free number, inputs the box and pin number and listens to the message. Since the voicemail box is private and the results can only be heard by the patient for whom the message is intended, it satisfies HIPAA regulations. Medical office efficiency and increased productivity make SecuReach a very cost effective system for physicians to implement. Other primary features include:

• Daily Alerts ­– The application keeps track of all ordered tests and referrals and notifies the staff when tests are not completed or messages are not retrieved through a system of daily alerts, which is updated in real time.

• Group Messaging – enables the user to send one message to a selected group of people all at once. Uses of this function include: notification to patients of office closing due to emergencies; staff notification of important office matters; office announcements to selected groups of patients.

• Appointment Reminders – The system calls the patient two days before the appointment with the date, time and location of the appointment. Such a system cuts down on no-shows for appointments which therefore increase productivity and receipts. An interface may be purchased which automatically retrieves appointments from the currently used scheduler to make the process even easier.

• Linked Tests – office can create test templates, which can be entered with a single click of the mouse, which ensures the practice that every test within a template is ordered and tracked. For instance, all 10-12 tests, which a pregnant patient needs, could be scheduled at the initial appointment preventing events like the third malpractice case listed above.

• Compliance ­– automatic test reminders are sent by both phone and email to patients - both for tests scheduled in the future and tests not completed. These reminders are built into the software and are sent with no additional input from the staff or cost to the provider.

Here is what current users are saying about SecuReach.

“We are constantly introducing new technology into the office that is supposed to make us more efficient. More often than not – there is very little time saved or even additional work associated with the new technology. SecuReach is the first technology that actually DOES save us time. In Internal Medicine – it is very important to communicate test results to patients whether the labs are normal or not. Phone tag is virtually eliminated with SecuReach and most patients LOVE that their results are getting communicated to them much faster.”

Helen L Rizi, MD
University Hospital Medical Practices (Cleveland) Center for Internal Medicine

Orange Village, Ohio

“I have found SecuReach to be invaluable to my practice. SecuReach is a reliable way to ensure that test results are delivered to patients. SecuReach has totally eliminated the time consuming act of trying to track down patients to inform them of test results. Patients are very pleased with the system and find it easy to use. They like the reliable delivery of their test results as well as the friendly reminders of their scheduled appointments. I would recommend SecuReach without hesitation.”

Linda T. Swan, MD

OB/GYN

Zanesville, Ohio

“SecuReach has cut down our follow-up time from approximately 15% of our practitioner’s time to closer to 5%... this has been an almost $40,000 savings in the first year, not to mention freeing up Nurse Practitioner time to provide revenue producing services. In addition, our customer satisfaction has greatly increased!

Set up was simple. The system is easy to use and can be easily modified to fit your affiliate’s specific needs such as using multiple languages so you can reach all of your customers.

The Daily Alerts are very helpful and the fact that designated Super Users can view all of your site’s activities, from the convenience of the main office, or even their home… is fantastic.

Triste Brooks, COO

Planned Parenthood of Greater Miami, Palm Beach and Treasure Coast

Over 300,000 patients are currently using our system in fifteen states. Several Medical Malpractice Insurance Companies give risk management discounts on insurance premiums for any clinician who uses SecuReach. Let us show you how we can cut your office phone traffic by up to 50%! Please call SecuReach at 1.800.760.9585 for more information and to schedule a 25-minute online web demonstration by a SecuReach physician.