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Watch for these common radiology mistakes
Robert Russo, MD, FACR, a radiologist in Bridgeport, CT, advises risk managers to watch for these common ways in which radiology findings can fall through the cracks and never be reported:
Patient names are mixed up. If a family is being treated by the same doctor, for instance, the report on the wife's CT scan can be put in the husband's file. Or if the patient's name is similar to another patient in the computer system, the findings may be reported to that person's doctor. When that doctor gets the report for someone who is not a patient and for a test that wasn't ordered, it may be ignored. The radiologist never knows that the report went to the wrong doctor.
Electronic medical records and automated filing systems will lower this risk, Russo says.
The patient provides the wrong doctor's name. When asked for the primary physician or to whom the results should be sent, the patient may provide the wrong name for various reasons. The patient may have several doctors or may have changed physicians recently. The risk is higher when physicians with the same last names spouses or father and daughter physicians, for instance work in the same practice.
"Sometimes the patient says Dr. Jones, and we may assume they mean the Dr. Frank Jones that we get many referrals from. Our staff puts that down and asks the patient to check everything and confirm that it's correct, but they don't catch the error either," he explains. "So, the report goes to Dr. Frank Jones instead of Dr. Emily Jones."
The radiologist does not follow up on messages. Getting in touch with the other physician to communicate results can be difficult, and it is common for the radiologist to have to leave multiple phone messages and send e-mails asking the doctor to call. With a busy practice, it can be easy for the radiologist to lose track of who has completed the loop and who hasn't. A formal tracking system, preferably automated, is required to avoid this error, Russo says.
A patient misses an appointment. The radiologist must have a system in place for notifying the referring physician if a patient does not show up for a scheduled test. If a patient is referred for a chest X-ray because lung cancer is suspected but then never shows up, the referring physician may never realize it if that office has no reminder system in place. Russo's radiology practice always calls the referring physician to report that the patient did not show up or cancelled a requested study.