With the complexity of busy general practice today, the doctor can sometimes forget about ordering pathology or imaging tests, or following up on test results.
Or the patient may have put off having the test performed.
Sometimes, this can lead to a delay in the diagnosis of a condition or recognition of the patient’s deterioration which might have been preventable.
Inadvertent errors could lead to court proceedings
Four scenarios result in less than optimal care being provided:
A test that should have been ordered is not ordered or deferred
In the right clinical context – for instance, HbA1c, iron studies, PSA, thyroid studies, and bone density – may be appropriate for a patient.
A test has been ordered but not performed
For whatever reason, a patient has chosen not to have the test performed. The responsibility for following up rests with the doctor.
The test has been performed but the results have not been reviewed
This commonly occurs when a doctor goes on leave if the buddy doctor has not reviewed the results, or the results come in paper form – eg on a discharge summary.
The test results have not been discussed with the patient
Telehealth can be an effective way to discuss results but sometimes a consultation is necessary. If that is difficult to organise, the closure of the process can fall off the radar.
Clinimetrix, a database management program that has been developed by GPs for GPs can help you monitor all of these scenarios easily and quickly.
For instance, you can easily obtain a list of patients with a diagnosis of diabetes who have not had an HbA1c measured in the previous 15 months. Or you could review those people aged 50 to 70 who have not had a bowel scan (FOB) in the previous 2 years.
Clinimetrix can provide you with a report showing those patients who have had a test ordered three months ago with no result received.
Regular review of these metrics monthly or quarterly will help to reduce the clinical risk to your patients and streamline your practice processes.
You can also look at the performance of each doctor in the practice against these metrics.
For instance, looking at the doctor’s ordering of PSA for males 40 to 75 may suggest that some doctors could think more about how to manage their older male patients.
The decision to order a test rests with the doctor but a performance review may prompt a doctor to consider their ‘usual care’.
Of course, hopefully, the outcome for a patient in any of the circumstances above may not be dangerous but the quality of care delivered suffers. But the outcome could be life-threatening.
Clinimetrix is an essential business management tool for the complexity of General Practice today, helping you understand the financial and clinical performance of your business.
Information is extracted from your patient management software each morning in just a few minutes.
See how to use Clinimetrix to generate reports for your practice by joining the members’ area here at https://www.clinimetrix.com.au/members-only.