December, 2007
Wishard Implements Veriphy Critical Test Result Management
-- Cat Vasko
An article in the July/August issue of the Journal of the American Medical Informatics Association examined the effectiveness of an electronic medical record (EMR) system for critical test result notification at the Veterans Affairs Medical Center in Houston. The results were disheartening: providers failed to acknowledge receipt of more than one third of transmitted alerts, and in 4% of these cases, the imaging study was completely lost to follow-up 4 weeks after the date of study.
Himanshu Shah, MD, medical director of the radiology department at Wishard Hospital, Indianapolis, understands firsthand the root of the problem. Until recently, Wishard was using a manual notification system for critical test results. "From a radiologist's standpoint, especially in a hospital, we do everything from scratch in the reading room," Shah said. Hearing him delineate the legacy process is almost painful: "The first step is to look at the requisition, decipher the name, page the doctor. Sometimes they'll call back and say, "I don't know about this patient." Wrong Dr Smith? Wrong resident? Wrong attending? What if the right person is on vacation? We can spend a lot of time just trying to find the right people and notify them of the results."
Shah explains that at Wishard, flaws in the critical result notification process became particularly worrying after The Joint Commission released new guidelines for documenting and tracking result reporting. Steven M. Scott, vice president of facilities and ancillary services at Wishard, was also concerned. " We were having problems with the quality piece-ensuring that the radiologists did communicate results to attendings, and that I could verify a year later that this really happened."
Scott heard about the Veriphy CTRM system from Vocada Inc, Dallas, at a conference. Thomas P. Kuster, director of imaging services at Wishard, was delighted, and not least because until that point there was no way to accurately measure compliance. "Only about 4? of the procedures are considered critical values that need to be reported," Kuster pointed out. "So we couldn't just do random audits, because the odds of a critical value being audited are so low. We were showing a false 100? compliant tracking methodology."
Scott said that with Veriphy, confirmation of compliance is rapid and accurate. "That's what makes the system so powerful for us," he said. "It's not some retrospective study. Should we discover that certain physicians or departments have a problem complying with our requirements, we can deal with that in real time."
So what's the new process, now that the Veriphy result management system is in place? It's not hard to explain, according to Shah. "It's a one-stop process," he said. "Just press a button and we're done. The system keeps track of things from there." Kuster and team have set windows during which they expect the physician to call back; if the time limit isn't met, Vocada staff automatically go to work tracking the physician down.
"You have a 100? likelihood of getting the right results to the right person," Shah said. "Some days it probably lops an hour off the radiologists' time. It's not just allowing us to read more, but allowing us to read more efficiently. We can get the images and the reporting done in under an hour."
http://www.imagingeconomics.com/issues/articles/2007-12_08.asp#3