Test-result services still leave room for liability

January 23, 2009

As for reducing the risk of liability in a malpractice claim, the most a voicemail service can do is prove that the patient either did or did not receive the test result and any message along with it.

Key Points

Suppose a company that merges telephone and web-based voicemail offers you a service that seems to make perfect sense: You read the patient's test results into a voicemail box that only you and the patient can access. There is a record of the results, including an archive of all voice files, for your own defense if things ever take a wrong turn.

We all spend a tremendous amount of time and money giving out test results, which are mostly normal. Some of us tell our patients to call back in a few days to get their results, which relieves us of the burden of remembering to call them. Eventually, though, an abnormal result falls through the cracks, and that's when everyone suffers.

With a voice service, patients are notified that there is a message waiting for them. When they call back, they are given the results and, presumably, a brief explanation, and the call and answer are documented for future reference. There are problems inherent in this scenario, however. First, you cannot assume that your patient is competent to interpret the test results without your help, so merely providing the results is not always as useful as it might seem.

"Why did you go to the doctor?" she asks your patient. You can see where this might lead. Of course, this can be averted by asking your patient to call in, but that eliminates one of the better features of the system-automatic notification.

Similarly, a patient could be negligent by leaving the mailbox number and PIN lying around the house for anyone to use. In this case, the physician would not be liable.

As for reducing the risk of liability in a malpractice claim, the most a voicemail service can do is prove that the patient either did or did not receive the test result and any message along with it.

What then, is the best of all worlds? A combination that can be used as an automated voice or e-mail system as long as you are sure that the correct person is receiving the message. You can also post the results on your website, accessible only with the patient's user ID and password, and notify him or her of their availability by e-mail.

This would give you the liability protection of preventing results from slipping through the cracks while also significantly decreasing your expenses and allowing your patients to access results on their own schedules.

On the other hand, nothing replaces an actual conversation. Remember, your duty is to provide standard or better medical care-not timely test results. Whenever results are abnormal, the patient must be asked to call or, better yet, come in to the office. And when the results carry potentially serious consequences, you should forget voicemail, e-mail, and web pages and call directly. You will not only help to prevent lawsuits and give the patient more confidence, but your humanity will return you to being a physician and not merely a "health-care provider."

The author is an internist and a health law attorney in Philadelphia. He can be reached at eshore@KaneShore.com
. Malpractice Consult deals with questions on common professional liability issues. Unfortunately, we cannot offer specific legal advice. If you have a general question or a topic you'd like to see covered here, please send it to memalp@advanstar.com
.