Patient Follow-up

Other problems arise with tracking patient care. HMOs and Medicare are often concerned about whether high-risk or sick patients are receiving follow-up care and tests, and that they are receiving this follow-up in a timely manner, said Anne Huben-Kearney, a clinical manager in the risk management department at ProMutual Group in Boston.
If physicians sign off on a patient’s diagnostic or lab work without looking at it carefully, or if the staff automatically files those results without showing them to the physician, the physician may never know of an abnormal result that requires follow-up.

Huben-Kearney suggests that offices have a policy that no test results are filed unless the physician has dated them and signed off on them. Documentation of telephone calls with patients is also becoming a bigger problem. Offices need to set up systems for delivering messages to a physician when a patient calls to ensure that calls are returned in a timely manner. Members of a physician’s office staff need to know the “magic words” that signify serious illnesses, such as chest pain, the worst headache a patient has ever had and other phrases that signal a life-threatening situation where the physician must be notified immediately. “The second part is documenting those calls,” Huben-Kearney said. “It’s a good practice to have telephone pads, but the best practice is to make sure it’s in the chart.” Companies like ProMutual help doctors develop and implement more detailed procedures to follow up with their at-risk patients, she said.

Next: Other Concerns