Tamara Johnson explains how tracking diagnostic tests and referrals keeps patients safe and your team protected—and shares strategies for staying organized.
One of the biggest challenges I see in medical practices today is staying on top of diagnostic test results, appointments, and referrals. There are so many moving parts in patient care and making sure none of them slip through the cracks is critical. Doing so is about more than protecting your organization from malpractice risk; it’s about protecting your patients’ health and trust.
Keep reading for strategies to help you keep up and keep everyone safe.
Key Takeaways:
- Adverse patient outcomes and resulting malpractice claims often stem from delayed or missed diagnosis or treatments.
- To prevent these issues, set up clear and reliable systems for routing and reviewing test results, as well as referral management.
- Also prioritize patient communication and documentation at every single stage.
The Problem: Not Having the Right Systems in Place
At Curi, clients often reach out to me to share just how difficult diagnostic test and referral tracking are. I hear that problems stem from multiple systems that don’t talk to each other, clinicians using different methods to follow up on pending results, and the high volume of EHR alerts. The resounding message: It’s a challenge to keep track of all the moving parts. We understand.
When I connect with clients, I always emphasize one key point: systematic management of diagnostic test results and referrals is essential.
Many adverse patient outcomes—and malpractice claims—stem from delayed or missed diagnoses or treatments. In a subset of Curi outpatient malpractice claims reviewed, 56% involved problems with follow-up and care coordination. To prevent these issues, it's important to have highly reliable systems in place.
The Solution: Create Highly Reliable Systems
Reliable follow-up care and test management is a complex process with multiple steps and accountabilities:
- Timely receipt of results
- Timely review of results
- Priority review of critical results
- Timely notification to the patient
- Referral management
- Missed and canceled follow-up appointments
A breakdown in any of these processes can lead to diagnostic error and patient injury. The following steps can help keep that from happening.
1. Start with a Solid Policy & Process
Every organization needs a clear policy and highly reliable workflows to make sure each report is reviewed and addressed promptly.
I often point clients to Curi's Diagnostic Test Tracking policy template as a great starting point. It walks you through how to keep a log of all diagnostic tests and explains the importance of assigning both a primary and backup staff member to regularly check for results.
It also sets expectations for when results should arrive, how to alert the ordering clinician if there’s a problem (like a missing specimen or a patient who didn’t complete the test), and how to route results for review.
2. Communicate Clearly with Patients
Once your internal processes are running smoothly, the next focus should be patient communication. While many patients now see their test results in the portal at the same time as the clinician, I recommend not relying on portal notifications alone. The potential for misunderstanding is just too high.
For routine results, a clear, written letter helps provide closure and reassurance. For critical results, a direct phone call from the ordering clinician is always best.
3. Document Every Step
Documentation is your best friend here. Every attempt to contact the patient and follow up should be recorded in the medical record—especially if a patient misses, cancels, or never completes a referral visit. Many patients don’t realize the importance of these appointments, so it’s our responsibility to help them understand and stay engaged.
4. Clarify Responsibility for Referral Appointments
I’m often asked where the clinician’s responsibility ends once a referral is made. While it might seem like it’s the patient’s job to follow through, the legal system often sees it differently. Courts tend to hold clinicians to a higher duty of care, expecting us to verify that patients kept their appointments and, if not, to take reasonable steps to ensure follow-up.
That’s why I recommend establishing a referral tracking system that mirrors your test result tracking. This ensures that every step of the care plan is completed and documented. Consistent documentation not only protects the organization but also demonstrates a genuine commitment to your patients’ well-being.
Bottom Line: Protect Patients & Your Practice
Building and maintaining strong diagnostic tracking processes takes effort, but once they’re in place, you’ll have peace of mind knowing your patients are safe and your team is protected.
If you’re ready to strengthen your approach, explore the Curi Risk Solutions Resources below for practical guidance and best practices on reducing diagnostic errors.
Curi Resources
- Diagnostic Error Toolkit
- Diagnostic Error: Awareness and Mitigation CME On-demand Webinar
- Risk Management Guide: Test, Appointment, and Referral Tracking
- Risk Mitigation Guidance Document: Testing and Results Processing
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