Messaging service archives messages, alerts referring docs to reports

VoiceLink protects radiologists from malpractice

Much of radiology is focused on getting information. But information is only effective if it gets where it is supposed to go. Peter White, the chief executive of Vocada, wants to make sure that happens.

The three-year-old communications company based in Dallas has developed a system for transmitting imaging results to referring physicians. VoiceLink digitally records diagnostic summaries dictated over the telephone by radiologists, then alerts referring physicians that the summary is available for them to call up. VoiceLink logs when and to whom the message was sent, archives the message into the system, and notifies radiologists when the message gets through to the referring physician. A tracking system identifies messages that are not picked up, allowing senders to make an extra effort to alert the intended recipient. VoiceLink also allows referring physicians to reply to messages when they are received.

About 170 radiologists at a half dozen medical facilities in California, Texas, Pennsylvania, and Tennessee have already signed on to the subscription service. Referring physicians are notified by telephone, cell phone, pager, fax, or e-mail, using contact information entered into a directory created by the radiologists.

The messaging system addresses a key recommendation of the Joint Commission on Accreditation of Healthcare Organizations for the read-back of all critical test results reported verbally or by telephone. Previously, JCAHO advised that this recommendation apply only to medications. In January 2004, however, the recommendation was extended to diagnostic tests, including imaging studies.

The primary goal of the system is to improve patient care, ensuring that results are transmitted correctly and quickly to referring physicians. VoiceLink also reduces malpractice liability by documenting that radiologists informed the referring physician of significant findings.

Vocada staff are marketing VoiceLink directly to end users, seeking out high-profile institutions. Among the current subscribers are Presbyterian Hospital of Dallas, Vanderbilt University Medical Center, and the University of Pennsylvania Hospital. The company is not seeking partnerships with the vendors of PACS or teleradiology equipment, at least not yet.

"It is really a stand-alone product," White said. "But over time, as we start to get more customers, it will be natural to have conversations (with OEMs) about integration with IT systems."

VoiceLink can be used to alert physicians to the availability of all diagnostic reports or just some. Radiologists at Presbyterian in Dallas, for example, personally call referring physicians with urgent results, using VoiceLink to convey messages of lesser importance.

The process begins with a phone call to VoiceLink's automated operator and the radiologist speaking the phrase, "create message." The radiologist then states the name of the referring physician and dictates a 30-second message, which typically includes the sender's and recipient's names, team members, notification rules, and findings. VoiceLink inserts the message into a digital envelope and-when the radiologist pushes the pound key on the telephone-sends a notice by telephone, pager, or fax to the designated physician that a message is available for retrieval.

The system is HIPAA-compliant in that the dictated results can be retrieved only by the referring physician, replying to the alert and accessing the archived digital message via telephone. VoiceLink notifies the radiologist when each message is retrieved, stores the messages, and documents their transmission and receipt for at least 10 years. The data can be searched and retrieved if the radiologist is ever questioned about whether or when a potentially significant finding was conveyed to a referring physician.

The fee for using the system is negotiated separately with each institution. There may be an upfront initiation fee followed by subscription fees that reflect the amount of usage. Major determinants are the numbers of radiologists and referring physicians.

"The value is tied back into the time savings provided by the application and the risk management benefit that is derived," White said.

The service sells itself, he said, once customers appreciate the need for ensuring that diagnostic results get to the intended persons. As obvious as this need may seem, it is not always apparent to prospective customers.

"It's really a matter of educating them about a system that is very new," White said.