I applaud the College’s efforts to improve asynchronous communication between physicians for consultations [BCMJ 2017;59:256].
I applaud the College’s efforts to improve asynchronous communication between physicians for consultations [BCMJ 2017;59:256 [9]]. I find inordinate delays in health authority transcription to be the major factor in critical delays for emergency patients. I sent a letter regarding a man with suspected aortic dissection to our tertiary hospital on 9 August with a full consult letter the same day after full workup. The receiving physician dictated a comprehensive, appropriate reply, which I received by fax on 16 August (likewise added to the EHR). The letter indicates a 7-day delay between dictation and transcription. I have no doubt that the Interior Health Authority (IHA) is working hard to improve this turnaround time, which I consider to be a dangerous practice for patient safety. The patients present back to my practice during the week, and I have no idea what the findings or treatment plans were because transcription takes a week. These timelines are typical in my experience.
I wondered if any standards were set for transcription times, and whether emergency physicians or IHA in-house consultants are obliged to use third-party dictation services when transcription times are dangerously long.
Perhaps there is a role for physicians to develop communication channels outside of the health authority.
Physicians are considered independent contractors and must meet professional and College standards. I would welcome any suggestions on how to do so within the current framework.
—Mike Figurski, MD, CPHIMS-CA
Big White, BC
The Interior Health Authority declined to provide a response, but has indicated that they will contact Dr Figurski directly regarding the incident he describes in his letter.—ED
Links
[1] https://bcmj.org/cover/october-2017
[2] https://bcmj.org/author/mike-figurski-md-ca-cphims
[3] https://bcmj.org/node/59
[4] https://bcmj.org/print/letters/re-who-checking-quality-referrals-college-replies
[5] https://bcmj.org/printmail/letters/re-who-checking-quality-referrals-college-replies
[6] http://www.facebook.com/share.php?u=https://bcmj.org/print/letters/re-who-checking-quality-referrals-college-replies&via=BCMedicalJrnl&tw_p=tweetbutton
[7] https://twitter.com/intent/tweet?text=Re: Who is checking the quality of referrals? College replies&url=https://bcmj.org/print/letters/re-who-checking-quality-referrals-college-replies&via=BCMedicalJrnl&tw_p=tweetbutton&via=BCMedicalJrnl&tw_p=tweetbutton
[8] https://bcmj.org/javascript%3A%3B
[9] https://www.bcmj.org/letters/who-checking-quality-referrals-college-replies
[10] https://bcmj.org/modal_forms/nojs/webform/176
[11] https://bcmj.org/%3Finline%3Dtrue%23citationpop