Tips for Test Tracking

As a part of its ongoing effort to help frontline HIV health care providers build and manage successful practices, the American Academy of HIV Medicine is pleased to present this second article of a four-part series on patient-centered HIV/HCV clinical practice. Tips in this series are drawn from site visits to practices nationwide, conducted as part of the Patient-Centered HIV/HCV Practice, a CME Series in Practice Management.

Physicians treating HIV and HIV/HCV co-infected patients track an immense amount of test work. Too often, results don't come back to the ordering physicians or come back too late. In addition, it is possible for a busy practice to get results and, in the rush of paper and patients, neglect to review them. The consequences can be serious, especially in the treatment of patients dependent on careful monitoring for proper pharmaceutical and other treatment. As a result, your practice needs to have a mechanism in place to track the ordering and reporting of results for each test ordered.

Here are some popular, paper-based monitoring methods. These methods may initially seem to take more time than simply making it up as you go along, but they are far more efficient in the end. Regardless, it is better to spend the time to track than to endanger your patients' health.

Advertisement
• Dictate or write tests ordered. A note in the record will serve as a "tickler" or reminder for staff when they preview charts before the patient's next appointment, prompting them to look for test results. For example, make sure when documenting a visit to include a comment that you ordered tests. You may also ask your nurse to create a special section in the front of the chart noting labs ordered, received and reviewed.

• Order them. Keep a copy of each test order form in a date-ordered tickler file. Develop a policy to review this file daily to ensure that results are back on the dates expected.

• Schedule. Schedule a follow-up appointment to review test results one to two weeks after the patient's initial appointment, while the patient is still in your office for testing. Staff should preview charts the day before the visit to make sure the results have arrived.

• Rack them. Hold patient charts with tests pending in a special chart rack until the results arrive. Order the charts by the date the results are expected. Review the rack daily for charts that remain beyond the time that you expected results. Once results are in, file the charts.

• Maintain a log of tests ordered. The log should include a column for "Results Returned." Highlight the appropriate entries as test results are received. Scanning the log daily for past entries that are not highlighted can alert you to test results have been delayed or lost.

You can use any of these methods that suit your workflow. The key is to have some sort of system in place that you use consistently and that is reliable. If none of the above paper methods suits your office, consider an electronic tracking system. Some connect automatically with major labs, delivering and entering results into an electronic medical record.

The Patient-Centered HIV/HCV Practice, a CME Series in Practice Management, is managed and sponsored by Professional Education Services Group, is supported through an independent educational grant from Roche Pharmaceuticals and is endorsed by the American Academy of HIV Medicine. Portions of the program were developed in conjunction with Physicians Practice.

To receive a complimentary copy of the Patient-Centered HIV/HCV Practice research findings or to subscribe to the related free newsletter, call Physicians Practice toll-free at 800-252-9684 or e-mail info@physicianspractice.com.

Back to The Nexus Spring 2004 contents page.