Another argument for patient's access to their test results

Vic Nicholls nichollsvi2 at GMAIL.COM
Wed Apr 23 17:23:14 UTC 2014


I've not seen DXplain but I have do know about Isabel. They dont like 
EHR's or just dont like the product?

I've seen it be more of an education or time issue. That and doctors who 
don't listen to patients.

Vic


On 4/23/2014 11:39 AM, Hoffer, Edward P.,M.D. wrote:
>
> Computer-based diagnostic decision support systems are readily 
> available. Best known are DXplain, on which I work, and Isabel. The 
> issue is getting physicians to use them.
>
> Truth of the matter is that diagnostic difficulties are the exception 
> (albeit a very important minority of visits).  90% of visits are to 
> follow known diseases and/or to treat easy acute illnesses.  When 
> diagnostic dilemmas are infrequent, getting doctors in the habit of 
> using them is hard.  The real answer, I believe, is making the 
> utilization automatic.
>
> *From:*Vic Nicholls [mailto:nichollsvi2 at GMAIL.COM]
> *Sent:* Wednesday, April 23, 2014 11:15 AM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* Re: [IMPROVEDX] Another argument for patient's access to 
> their test results
>
> How can we leverage those paper essays and check off sheets that we 
> get from docs? I can get a 4-8 page check off the problem list, 
> wouldn't it be easier to have that done on computer and then spit out 
> a summary for the physician?
>
> The other is what about a computerized list of potential dx's and a 
> differential dx list to help the doc? They could go through and see 
> what looks good and choose it. Then if the first dx isn't right, go 
> down the differential list and see what looks good from that?
>
> Not saying docs can't go out of it but something a little better would 
> seem to help.
>
>
> On 4/23/2014 10:06 AM, Robert Bell wrote:
>
>     How can we focus on improving errors in diagnosis if the basic
>     communication systems are so imperfect?  First things first?!
>
>     Rob Bell
>
>     Sent from my iPad
>
>
>     On Apr 23, 2014, at 3:58 AM, "Hoffer, Edward P.,M.D."
>     <EHOFFER at MGH.HARVARD.EDU <mailto:EHOFFER at MGH.HARVARD.EDU>> wrote:
>
>         I tell my patients that while few doctors would consciously
>         ignore abnormal test results, a small percentage of test
>         results get lost by the lab, misfiled, sent to the wrong
>         doctor who discards them, etc.  Hence a “closed loop” is much
>         safer than “no new is good news.”
>
>         Ed
>
>         Edward P Hoffer MD, FACC, FACP
>
>         *From:*Peggy Zuckerman [mailto:peggyzuckerman at GMAIL.COM]
>         *Sent:* Monday, April 21, 2014 12:18 PM
>         *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>         *Subject:* Re: [IMPROVEDX] Another argument for patient's
>         access to their test results
>
>         Quite similar to this is the very frequent situation in which
>         a patient is told re the blood labs, "We'll call if there is a
>         problem; otherwise, don't expect to hear from us".  Stats
>         indicate that some 15-18% of labs with abnormalities are not
>         reported to patients.  With the millions of tests done, that
>         percentage reveals a tremendous weakness in our system, and
>         another reason to be pro-active in getting and reviewing one's
>         own labs.
>
>         Moreover, that statistic does not indicate whether the
>         reported problems suggested by the abnormal labs ever trigger
>         the proper follow up, not to mention are used efficiently in
>         the diagnosis.  Case in point:  a PSA test is higher than
>         normal, and patient is told to see specialist.  Is there a
>         formal referral, are the abnormal labs provided to the new
>         specialist, are new labs prescibed, does the GP inform expect
>         and prepare for a response from the specialist?  No stats on
>         any of that, which are certainly "delayed diagnosis" incidents.
>
>         If these labs and the value of them were EXPLAINED to
>         patients, so that they understood the importance of the
>         abnormal reading, more appropriate follow up by both patient
>         and doctor would happen.
>
>         Peggy Zuckerman
>
>         On Sun, Apr 20, 2014 at 8:02 PM, Graber, Mark
>         <Mark.Graber at va.gov <mailto:Mark.Graber at va.gov>> wrote:
>
>         In a very disturbing story this week, a radiology tech was
>         accused of notifying 1000+ women that their mammagrams were
>         normal, although she didn't know this to be true, and some in
>         fact were not. http://www.today.com/video/today/54989210#54989210
>
>         Its my understanding that all women are supposed to receive a
>         copy of their test result, and its not exactly clear from this
>         report if the tech just gave women a verbal 'ok', or if she
>         actually altered the radiologist's report.  This is a class of
>         diagnostic error I've never encountered before, but I'm hoping
>         that the directly-mailed results mitigated the tech's false
>         assurances.  If anyone has access to more facts on this case,
>         I'd be interested to hear them.
>
>
>         Mark L Graber, MD FACP
>         Senior Fellow, RTI International
>         Professor Emeritus, SUNY Stony Brook School of Medicine
>         Founder and President, Society to Improve Diagnosis in Medicine
>         MARK.GRABER at IMPROVEDIAGNOSIS.ORG
>         <mailto:MARK.GRABER at IMPROVEDIAGNOSIS.ORG>
>
>         To unsubscribe from the IMPROVEDX:
>         mail to:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:to%3AIMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>         or click the following link:
>         IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
>         Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
>         For additional information and subscription commands, visit:
>         http://www.lsoft.com/resources/faq.asp#4A
>
>         http://LIST.IMPROVEDIAGNOSIS.ORG/ (with your password)
>
>         Visit the searchable archives or adjust your subscription at:
>         http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
>
>         Moderator: Lorri Zipperer Lorri at ZPM1.com
>         <mailto:Lorri at ZPM1.com>, Communication co-chair, Society for
>         Improving Diagnosis in Medicine
>
>         To unsubscribe from the IMPROVEDX list, click the following
>         link:<br>
>         <a
>         href="http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1"
>         target="_blank">http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1</a>
>         </p>
>
>
>
>
>         -- 
>         Peggy Zuckerman
>         www.peggyRCC.wordpress.com <http://www.peggyRCC.wordpress.com>
>
>         ------------------------------------------------------------------------
>
>
>         Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
>         To unsubscribe from IMPROVEDX: click the following link:
>         http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
>
>
>         or send email to:
>         IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>
>         Visit the searchable archives or adjust your subscription at:
>         http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
>
>
>         Moderator: Lorri Zipperer Lorri at ZPM1.com
>         <mailto:Lorri at ZPM1.com>, Communication co-chair, Society for
>         Improving Diagnosis in Medicine
>
>         To learn more about SIDM visit:
>         http://www.improvediagnosis.org/
>
>         The information in this e-mail is intended only for the person
>         to whom it is
>         addressed. If you believe this e-mail was sent to you in error
>         and the e-mail
>         contains patient information, please contact the Partners
>         Compliance HelpLine at
>         http://www.partners.org/complianceline . If the e-mail was
>         sent to you in error
>         but does not contain patient information, please contact the
>         sender and properly
>         dispose of the e-mail.
>
>         ------------------------------------------------------------------------
>
>
>         Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
>         To unsubscribe from IMPROVEDX: click the following link:
>         http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
>         or send email to:
>         IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>         <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>
>         Visit the searchable archives or adjust your subscription at:
>         http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
>         Moderator: Lorri Zipperer Lorri at ZPM1.com
>         <mailto:Lorri at ZPM1.com>, Communication co-chair, Society for
>         Improving Diagnosis in Medicine
>
>         To learn more about SIDM visit:
>         http://www.improvediagnosis.org/
>
>     ------------------------------------------------------------------------
>
>
>     Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>     <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
>     To unsubscribe from IMPROVEDX: click the following link:
>     http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
>     or send email to:
>     IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
>     <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>
>     Visit the searchable archives or adjust your subscription at:
>     http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
>     Moderator: Lorri Zipperer Lorri at ZPM1.com <mailto:Lorri at ZPM1.com>,
>     Communication co-chair, Society for Improving Diagnosis in Medicine
>
>     To learn more about SIDM visit:
>     http://www.improvediagnosis.org/
>
> ------------------------------------------------------------------------
>
>
> Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG 
> <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
>
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 
>
>
> or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG 
> <mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>
>
> Visit the searchable archives or adjust your subscription at: 
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX
>
>
> Moderator: Lorri Zipperer Lorri at ZPM1.com <mailto:Lorri at ZPM1.com>, 
> Communication co-chair, Society for Improving Diagnosis in Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>








To unsubscribe from the IMPROVEDX list, click the following link:<br>
<a href="http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1" target="_blank">http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1</a>
</p>

HTML Version:
URL: <../attachments/20140423/87203517/attachment.html>


More information about the Test mailing list