Allegations of “failure to diagnose” or “delay in diagnosing” are common in medical malpractice claims. Analysis of these claims shows that failure to follow up on or communicate test results to the patient can contribute to these allegations. This issue can result when a patient fails to keep an appointment with a healthcare provider or does not have the recommended test or treatment. One way to prevent this issue is to use a patient tracking and follow-up system.
Q. What is a patient tracking and follow-up system?
A tracking and follow-up system is a way of controlling the flow of patient information through the medical office. It includes tracking of results, referrals to specialists, patients who miss appointments and documentation of attempts to contact the patient. (The goal is to make the information available to the physician for timely clinical decision making).
Q. Do I need a follow-up system in my practice?
Yes, regardless of your specialty, allegations of failure to follow up can be difficult to defend if you cannot prove that reasonable attempts were made to contact the patient who missed a follow-up appointment, recommended test or appointment with a specialist.
Q. What are reasonable attempts to contact the patient?
It depends on the severity of the patient’s condition, the clinical significance of the visit/test and the risk associated with missing the test or office visit. Often the physician is unaware that the patient failed to return as requested so months may pass and conditions worsen.
Q. What is the patient’s responsibility?
Court decisions have held that it is the medical professional’s responsibility to make reasonable attempts to contact and encourage the patient to return for needed follow-up, as the medical professional appreciates the “seriousness” of the problem and the patient may not.
Q. What are common situations that require follow-up?
- Results of a recommended diagnostic test are not received
- A patient does not come for a return appointment (a no show, missed or canceled appointment)
- A specialist’s findings are not received
Q. What are the essential elements of a follow-up system?
- Define which physician recommendations require follow-up
- Establish a method for determining compliance with physician recommendations, such as EMR
- Create a written policy on how the tracking and follow-up system will work
- Train staff
For assistance in setting up or evaluating your tracking and follow-up system, please contact the LAMMICO Risk Management and Patient Safety Department at 504.841.5211 or 800.452.2120.
Practice managers can log in as a member at Lammico.com/login to access the online course “Patient Tracking and Follow Up” and earn 0.25 Risk Management Premium Discount credit for their providers.