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Fax glitch results in DI reporting delay

CALGARY – Problems with fax software at Calgary hospitals may have delayed the transmission of up to 40,000 radiology reports, such as mammogram results, to referring physicians last year.

The Calgary Health Region revealed in January that problems with software responsible for faxing radiology results began in May 2007 and continued until late July, when the region notified nearly 2,000 physicians about the delayed reports.

The health authority said it’s possible patients were adversely impacted, although they didn’t know of any cases, according to a report in the Calgary Herald.

Physicians said the worst-case scenario would be a delayed diagnosis of a disease such as cancer, where timely treatment might stop the illness from spreading.

“It’s one of those technical glitches that occurs in a system and it’s really unfortunate because it has the potential to impact patient care,” CHR spokesman Mark Kastner said in an interview with the Calgary newspaper.

Kastner said any patients whose reports may have been delayed would have since received the correct information from their physician, noting doctors’ offices have now had the reports for several months.

Opposition parties called the situation a “mess,” adding the CHR should have announced the problem last summer.

“There may have been a lot of people delayed in getting treatment for cancer and other life-threatening issues,” said Laurie Blakeman, the Alberta Liberals’ health critic. “People were probably failed.”

The CHR’s fax problems come more than two years after another computer glitch at the health body, where physicians viewed incorrect lab test results for 2,000 Calgarians during a two-month period. No patients were harmed during that mix-up.

In this latest instance, the fax problem related to radiology reports from imaging tests such as X-rays or CT scans, which are performed to help doctors diagnose a wide range of conditions. CHR officials say a configuration problem with the software responsible for faxing radiology results from its hospitals and clinics to doctors offices likely began last May.

Doctors offices that receive radiology reports by mail or courier were not affected.
In June, the CHR noticed it was receiving an unusual number of calls from physicians saying they didn’t receive faxed results from radiology exams.

It wasn’t until July 20 that the CHR identified the problem and sent a letter explaining the issue to the 1,750 Calgary doctors who had opted for faxed radiology reports. CHR then re-faxed the reports to physicians.

The region’s diagnostic imaging department, however, later became concerned that they may not have sent all the radiology reports to all physicians’ offices. Finally, in September, the CHR faxed out 40,000 radiology reports to Calgary physicians as a precaution, sending results from all radiology exams done during that period, although it isn’t clear how many of those didn’t make it to doctors’ offices.

The health authority said it has fixed the computer problem and is still reviewing its response to the situation.

Dr. Linda Slocombe, a family physician and incoming president of the Calgary and Area Physicians’ Association, said most physicians would notice if they didn’t receive an expected radiology report for a patient and request the document again. But she said the delayed reports were a risk for patients.

“The potential harm is the delay in getting the information,” she said.

The Liberals’ Blakeman also questioned why it took the CHR until July 20 to notify physicians when they first realized there might be a problem in June. “It took them an awful long time to get into gear and address it,” said Blakeman.

The computer problems also come as Alberta develops an electronic health record for every person in the province. While health-care providers say electronic records will help patient care in many ways, they say the CHR radiology issue also shows the potential for problems.

“It’s one of the risks with electronic systems,” said Slocombe. “When things go wrong, they really go wrong.”

However, recently smarter technologies have emerged that are able to use a variety of methods to send reports to doctors. If fax is selected as the reporting method of choice, and the transmission fails, the system can automatically switch over to an automated phone call.

Moreover, these systems can require an acknowledgement from the referring physician in urgent cases, thereby ensuring a doctor is aware of results that may need swift action – such as tumour or aneurysm. If the acknowledgement doesn’t occur in a predetermined amount of time, an alert will go out to another physician.

Solutions of this sort are now being introduced to market by firms such as Dictaphone and Agfa.