john dooley wrote:
I would suggest that best practice would have signed agreements stating
where responsibility lies for standard and urgent results and the
methods of delivery for each category. Seeing as most clinical packages
do NOT produce HL7 ACKS then the best the path companies can do is prove
with an ack that their download client received the files.
My system provides these acks and I believe at least one case
surrounding a missed abnormal PSA found against the GP and not the path
company where a result was lost to follow up.
I think the responsibility for following up a test result should 100%
lie on the shoulders of the requesting doctor :) You order it, you make
sure you get a result. There are so many reasons where the chain can
break down and these are beyond the pathology firms responsibility and
control. From my standpoint if I have a fax transmission log or an
electronic ACK that your practice got the result and something untoward
crops up - it aint my fault.... The college had some concerns about the
"medicolegal exposure" of elecronically ordered tests that patients
never went to have especially relevant when maybe 20% of tests never
get done -(what do you do if the dr orders a PSA and the patient never
presents? how far do you go? how far do the courts expect? like pap
smears and failure to return for a smear with multiple letters etc?)
That said I am of course committed to ensuring to the best of my ability
that results are delivered and acknowledged to referring doctors, i
routinely send critical diagnoses by 2 delivery methods regardless of
"standard" for that practice - eg melanomas get a fax and an electronic
copy or a hard copy.
On a practical note most IT issues lie at the receiving end and relate
to variable quality of implementation within GP and specialist practice.
I would recommend you all immmediately harass your clincal software
vendors to make sure they institute HL7 acks and complete the chain and
institute internal followup/matching of requests and results. That is
vital to avoiding misses.
JD
nexus pathology
John,
have a look at the RACGP 3rd edition standard:
Criterion1.5.4_System_for_follow_up_of_tests_and_results
You can access it at:
http://www.racgp.org.au/standards
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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