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IT Matters – Critical test result management

by Sean Ruck, Contributing Editor | September 03, 2015
From the September 2015 issue of HealthCare Business News magazine

So, how do you handle this? You might say, the easiest way to figure this out is to look at who ordered the test and get the results back to them. But Hirschorn cautions against that approach.
“Frequently, for valid reasons, that’s not possible. Take the outpatient setting for example. What if the doctor is on vacation or maybe in the OR? Or some other perfectly valid reason they’re unavailable. So there has to be someone covering for the doctor.”

That someone, as previously noted, has to hold a medical certification, but after that requirement is met, the field opens up. If a physician’s assistant is one of the links in the process chain, he or she can receive the message and then use the appropriate means of escalation. “In the inpatient setting — it’s a different problem,” says Hirschorn. “Maybe the doctor went off-shift and the doctor in the next shift is taking care of the patient now.”

It’s up to the hospital and the teams to determine who will be in charge. Some hospitals have computer systems in place to see who’s taking care of which patients, but that’s not to be confused with who the patient is actually assigned to.

“I’ve almost never met a nurse who, if you ask them who the doctor is taking care of the patient, they couldn’t tell you. Or if they weren’t familiar, they’d get it figured out.” Once the nurses get it figured out, the doctor still needs the heads-up. And that’s where technology helps again.

Once the doctor is identified, there are systems out there that try to deliver the message. They’ll take a message either by voice or text, and then try to page or alert the doctor currently taking care of the patient. So if the doctor you think is taking care of the patient doesn’t respond in a given time frame, the notification process escalates. Some places have success with the automated systems. In other facilities, physicians rejected the machine-based system, often because they claimed it had difficulty identifying the right person to communicate with. There are some places that deliver the message to a cell phone app.

“I created a system that serves as a work list for the clerks in our radiology department. It gives urgent versus important — don’t need to call them out of bed to answer, but they need to know about it,” says Hirschorn.

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