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IT Matters – Critical test result management

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

When people use the phrase “a matter of life or death,” it’s often hyperbole.
Of course, for medical professionals dealing with critically ill patients, there’s less exaggeration. When a patient has serious indications and tests are ordered, making sure the results are delivered to the right doctor at the right time and even in the right format or way, can make all the difference.

To get an idea of how the process flows when it’s being carried out successfully, HealthCare Business News spoke with Dr. David Hirschorn. Hirschorn, the director of radiology informatics at Staten Island University Hospital, is well-acquainted with the technology and steps to take in order to successfully manage critical test results.

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Much of the challenge as Hirschorn sees it is to make sure the staff involved understand and follow procedure. Just like other hospital-based activities, if one individual doesn’t stick with the game plan, the result can be a cascade of problems. Hirschorn offers an example: “Radiologists have a case to read and they come to a point that requires communication. There are some things that require routine communications and acknowledgement of the message,” he says. “If you see a chest X-ray where a patient is in trouble and the physician needs to know about it right away, just writing a report won’t do it.”

Hirschorn says that the notification needs to escalate and it needs to clearly be identified as an urgency communiqué. Following procedure (which may differ from facility to facility), maybe a phone call or a page will be made and then the doctor caring for the patient will be informed. The doctor might also be tracked down for a face-to-face briefing.

“If you see a feeding tube in the lung instead of the stomach or you see a patient lung collapsed — and maybe no one else realizes because their oxygen saturation is still good and their lungs are working fine,” those are two situations that need immediate attention, says Hirschorn. Those types of problems are fairly common, but they can still cause serious harm or death if not handled promptly. “It requires the right person at the right time to get the message in the right way,” says Hirschorn.

It’s not enough or OK just to have the secretary at the doctor’s office receive the message. They’re not legally required to get the message to where it needs to go next, says Hirschorn. Ultimately, the message needs to get to a certified health care provider, either a doctor or a nurse practitioner, for example. “Therein lies the biggest challenge — if radiologists knew they could pick up ‘the Bat Phone’ and they could immediately get the physician they needed, they’d be thrilled. But that’s not reality. First thing you need to find out is who the contact is, and second, how to reach them,” says Hirschorn.

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