Health Imaging & IT - March 2008 - (Page 16)

The Human Touch: Critical Test Results Management Managing traffic flow Like all hospitals nationwide, North Shore Medical Center in Salem, Mass., grapples with JC requirements—particularly a recent ruling that calls for acknowledgement of critical results. The conventional process of reporting results via fax or phones lacks an audit trail. In 2006, the medical center decided to invest in a new approach and deployed Nuance Veriphy CTRM solution. “Veriphy focuses on the 5 percent of results that need follow up,” says Barbara Corning-Davis, enterprise clinical imaging manager. “It closes the communication loop and ensures that results don’t fall through the cracks.” The color-coded system divides critical results into three categories: red, orange and yellow. A red, or life-threatening, result requires a one-hour response from the ordering physician. An orange, or critical, finding such as a new fracture requires an 18-hour response. And less critical results such as suggested malignancies are coded yellow and require follow up. “Our radiologists like the system because it confirms that the ordering physician has received results,” says Corning-Davis. “The system is also popular with referring physicians because it helps them better manage their time. A simple glance lets them know if a result requires immediate follow up.” University of Colorado Hospital in Denver turned to Veriphy late in 2007 after a traumatic year during which the radiology department moved, installed a new PACS and upgraded the RIS. “We wanted to alleviate the pressure on radiologists,” says PACS Administrator Michael Cain. “It had become very difficult for them to track the correct person for results. Plus, most radiologists are not very good at documenting communication of results.” Veriphy addresses two challenges; it automates the documentation process and it changes the culture among referring physicians by forcing them to listen to messages. The hospital adapted the software to divide findings into two categories: critical results (pertaining to loss of life, limb or eyesight) 16 Health Imaging & IT | March 2008 must be communicated within an hour and significant findings that require attention, but can wait for several hours or longer. Since installing the system, the hospital also has seen radiologists’ productivity increase because they need to spend less time on the phone communicating results. heavy referrers, can be targeted in multiple ways including email and in person at staff meetings, so they are aware of the new system and their responsibilities. Advice from the field Regardless of the CTRM solution a hospital uses, technology is not a panacea. In fact, the very process of considering a CTRM system will shine a spotlight on inconsistencies and flaws. CTRM is mission critical; in an ideal deployment, it integrates with other systems so data aren’t housed in a silo. Hospitals should look for a system that can integrate with voice recognition and EMR solutions, says Corning-Davis. Integration streamlines processes and can improve productivity. “CTRM requires good human factors management and a commitment to high-level customer service,” adds Halsted. Many pioneers boosted the success of their project by involving hospital administration including quality improvement and risk management teams from the project’s inception. It’s also important to remember that the CTRM process extends beyond radiology. “A successful implementation should include announcements to referring physician offices and staff because they receive and handle faxes,” says Corning-Davis. Cain of University of Colorado Hospital recommends new CTRM sites stagger deployment to the target audience. The academic hospital started with inpatient results and followed with outpatient results after three months. The power of integration Integration between CTRM systems and other information systems can boost the utility of an implementation. North Shore Medical Center aims to integrate Veriphy with its EMR to further streamline processes and align radiology communication with lab results notification. At University of Colorado Hospital, Veriphy is integrated with PACS, which means the radiologist simply switches to a Veriphy window if he or she detects a critical finding. After typing in the patient’s name or record number, the radiologist records a message to send to the referring physician according to the preferred means of contact. A permanent log with physicians’ name and date is maintained in the system. The hospital plans to integrate the CTRM software with its voice recognition platform in the future. The integration will save keystrokes as the radiologist can initiate the call without retyping the patient’s name or record number. IT-lite Unlike many radiology projects, CTRM is an IT featherweight. RadStream is built to run as independent software; it pulls data from the RIS and runs on existing workstations. In addition to running as a standalone solution, RadStream can be embedded into any PACS. “Veriphy is an IT dream project,” claims Corning-Davis. The CTRM system requires no IT infrastructure. Data are stored offsite. IT did integrate Veriphy with its pager system for pager forwarding, but the process was quite straightforward. The only other pre-deployment needs are training and education. A five-minute overview of the system suffices for radiologists and reviewing physicians, says CorningDavis. Ordering physicians, especially The case for CTRM IT systems that focus on CTRM can address a number of critical issues. They can streamline and improve results notification to boost patient safety, improve radiologists’ productivity and enhance service to referring physicians and patients. At the same time, systems simplify JC compliance and provide an audit trail that may prove useful in the event of legal disputes about results communication. Training and IT requirements are minimal. The upshot? CTRM systems represent an investment worth making. HealthImaging.com http://HealthImaging.com

Table of Contents Feed for the Digital Edition of Health Imaging & IT - March 2008

Health Imaging & IT - March 2008 Table of Contents On the Web The Enterprise: Communicating Better News Update Critical Test Results Management: The Human Touch The Changing Face of the Cath Lab Cardiovascular CT: A Clinical Boon Cardiology PACS: Solutions to Fit Your Needs ACC 08: Building Quality & Value Together Picking the Perfect PACS Displays PET/CT: A Game-Changer in Cancer Patient Management DR: You Gotta Have IT – Delivering Speed, Efficiency, Savings Laser Imagers: Answering the Call for Hard Copy Reader's Resources Stat Sheet

Health Imaging & IT - March 2008

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