Lost Tests Resulting in Patient Injuries or Deaths

EHM. Why is this an issue?

Steven Pap. The Institute of Medicine in their report of November 1999 found that medical errors are responsible for up to 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. And these numbers are the tip of the iceberg – they do not reflect the morbidity that also attends to these medical errors. It is a national scandal that offices do not utilize available automated aids to track and communicate lab tests to patients and avoid these results entirely. It is ironic that the same physician who embraces the latest in technology in the operating room, steadfastly resists automated aids in the office that could improve patient safety and reduce malpractice risk.

EHM. What can be done to reduce these errors?

SP. An office test tracking and communication system must process – perfectly – the average of 2500 tests that the typical physician orders in a year. The ideal system should:

• Enter all tests, referrals and follow ups into the tracking system.
• Send email and voice messages to remind patients of tests that need to be done.
• Record test result messages for patient retrieval.
• Notify patients that test results are available and provide a vehicle for patient retrieval.
• Send reminders when tests are not completed.
• Track all tests, referrals and follow ups and leave a daily alert for all staff members and physicians for tests not completed and messages not received.
• Record and save all correspondence including voice message files in case of legal issues.

These tasks seem impossible to accomplish until you consider that one can automate every part of the process except the bullet points in bold type above. This allows the office to institute a sophisticated test tracking and communication system while not creating any additional work for its beleaguered staff! 

EHM. How does an automated system like SecuReach work?

SP. A system must track tests from the date the test is ordered until the patient receives the results in order to close the loop. SecuReach delivers this solution as an ASP (Application Service Provider). The only requirement 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 web 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. All correspondence is recorded and available to the practice as necessary. The application keeps track of all 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. Compliance is improved by a series of automated reminders to the patients by both email and phone. Office phone traffic is decreased by up to 50%. The efficiencies introduced by automating the process allow clinical staff to concentrate on patient duties instead of clerical ones. All this can be accomplished for less than 4 dollars per physician per day.

Dr. Steven M. Pap is the President of SecuReach Systems, Inc. (www.secureachsystems.com). He graduated from the Ohio State University College of Medicine in 1977 and was in private practice as an OB/GYN for 24 years. In 2005, he founded the company and designed its automated test tracking and communication system. Over 400,000 patients are currently using SecuReach in 20 states.