Diagnostic physicians, who rely on diagnostic tests, need to inform referring clinicians when test results produce urgent or unexpected findings. Test communication failures for diagnostic testing are placing physicians at an increased risk of medical malpractice claims, as reflected in an article selected as the "CME Activity of the Month" in the most recent edition of Journal of the American College of Radiology (JACR).
During the past decade, clinicians have dramatically increased their orders for diagnostic examinations. During the period between 1996 and 2003, there has been an increase by approximately 40% for malpractice payments related to diagnosis. This problem was reflected in the article by Brian D. Gale, MD, MBA, assistant professor of radiology at SUNY Downstate Medical Center in Brooklyn.
During the period of 1991 to 2009, National Practitioner Data Bank data showed communication failure awards was responsible for an increasing proportion of total United States malpractice awards for providers. The proportion jumped from .93% in 1991 to 2.31% in 2009. The total indemnity payout for all medical specialties claims dramatically rose from $21.7 million in 1991 to an alarming $91 million in 2010. This averages out to a $4.67 million increase annually. Factors that contributed to the communication failures included long turnaround time, delays in reporting findings, and failure of the patients and physicians to receive the results.
There is hope for improvement however. Dr. Brian Gale suggests that using semi-automated critical test result management systems may help to improve the patient safety and work flow, improve the notification reliability for everyone in the loop, and provide legal documentation. Dr. Gale suggests healthcare organizations need to have a clear set of policies in place to address reportable test results, to make sure patients and referring providers are notified and followed up with.
