Health Information Compliance Alert

10 tips on making sure patients, physicians see test results.

If you're not vigilant about how you're handling medical test results, you could be violating patients' privacy.

Too many practices let reporting test results go by the wayside and don't have a foolproof system for notifying patients -- or even making sure physicians see test results in a timely fashion.

Here are some tips for making sure your office handles test results properly:

1. Create a "closed loop" system. Have a procedure in place to notify patients of test results or bring them back in for follow-up visits, advises Elizabeth Woodcock, director of knowledge management for Physician Practice Inc. in Glen Burnie, MD. There's no legal requirement to notify patients quickly, but there are public relations issues as well as health implications for being slack about reporting test results, she says.

2. Don't ever tell the patient, "If you don't hear from us, assume everything is okay," warns Jack Valancy, a consultant in Cleveland Heights,OH. No news isn't necessarily good news if the test results were misrouted or mishandled. It's better to say, "If you don't hear from us by this date, please call in." That way, if all else fails, you'll have a phone call from the patient as a "backstop."

3. Keep outstanding test results visible. One way to do this is to have a copy of the requisition for the test out in a visible location in the office, and have someone check those test orders every day to see if any of them should have received results already, says Valancy. Another way is to have a special shelf for patient charts with outstanding tests, says Woodcock.

4. You can also use a computer system to alert you if you don't post results for tests your doctor ordered, says Valancy.

5. Keep a log of outstanding test results, and use a highlighter to mark when results come in, advises Woodcock. Every week, look over the log for entries that are overdue. Mark entries with an asterisk or other sign after patients have been notified.

6. Tailor reporting to the type of test. For benign tests such as Pap smears or cholesterol tests, you may be able to notify patients of results electronically or via letter, says consultant Phyllis Yingling with Apple A Day in Hilton Head, SC. But for problem-driven tests, it's important to bring the patient back for an office visit to receive the results.

7. Figure out reporting at the time of the test. If the test will require a follow-up visit, schedule that visit when the patient is in the office for the test, Yingling says. Or if you're going to notify the patient of the results at home, set up the appropriate delivery method during the test visit. Some practices give patients a postcard to fill out with their addresses. This makes it easy to mail the results of normal Pap smears and other tests.

8. If a routine test comes back positive, bring the patient in for a follow-up visit to notify them of the results and discuss treatment options, Yingling advises.

9. Pay attention to HIPAA. You can't let a patient's family members or others know about test results. If you use a postcard, it must contain very little information, says Yingling. And if you notify a patient via phone, you can't leave a message that a family member might hear. There are services that will allow you to report results securely via phone or Internet, says Woodcock. For example, you can give patients PIN numbers with which they can access a secure Web site or call a toll free number to obtain test results.

10. Tailor reporting to your patient population. If your patients are technology-phobic, harder to reach, or need a lot of explanation of test results, then you should definitely bring them back for a follow-up visit even for routine tests, Woodcock advises.