A new study, published in the Annals of Internal Medicine, sought to examine the failure to inform rate of abnormal test results across 23 primary care practices. The results were surprising, but not altogether unexpected, in today’s setting of busy practices and a shortage of primary care physicians.
The study identified 1889 abnormal test results. Of these, there were 135 failures to report, or failure to document that the lab results had been reported to the patient. This translated to a 7.1% failure rate, or approximately 1 out of every 14 abnormal test results.
What are some of the common reasons for this failure?
Many practices do not have explicit practices in place for informing patients about abnormal test results. In some practices, doctors notify the patients themselves, and in others, support staff provides this service. With no comprehensive plan in place, abnormal test results may “slip through the cracks”. The doctor may not see your test result, the doctor may not be notified by the lab or testing facility, the report may get “buried” under a pile of papers awaiting disposition, the report may get filed before the doctor sees it…the list of possible explanations for failure to inform is endless.
Do electronic medical records help doctors keep track of test results?
The study highlighted the fact that medical practices which utilized both paper charts and an electronic health record had the highest failure rates. This may be because electronic health records are new, and many practices are still “working out the kinks”. Electronic health records are not infallible, and there needs to be a system in place to deal with abnormal lab results and the reporting of these results. Without such a check in place, it is not surprising that results are sometimes missed.
What can you do to protect yourself?
Patients need to be their own best advocate. If you have testing done, and do not hear back from your doctor concerning the results within a reasonable time frame, you should contact your doctor’s office. Do not assume that “no news is good news”; it may be that your result has not come to the attention of your physician. Ask for paper copies when necessary. Although it is the physician’s responsibility to inform you should you have an abnormal result, accidents do happen. To ensure it does not happen to you, follow up after you have had tests done.
Related Links:
Proposed Changes to Healthcare Means Worse Shortage of Physicians from Health Guru
Study: Direct Reporting of Laboratory Results to Patients by Mail to Enhance Patient Safety
