How to manage mis-directed In-Basket results.

Problem: Laboratory results, intervention reports, clinical notes or other patient information can occasionally get mis-directed. The affected prescriber may see Connect Care In-Basket notifications about patients that are not within the prescriber's circle of care. Indeed, reviewing this information inappropriately could constitute a privacy breach. What to do?

Considerations: In-Basket or Chat messages that link to patient health information should relate to patients with whom the receiving prescriber has, has had, or will have a care relationship (circle of care).

Mis-directed messages may relate to mis-identification (another provider selects the wrong physician to copy results to), mis-registration (clinic or admitting process incorrectly associates the patient with the wrong physician as an admitting, responsible, consulting, ordering or authorizing prescriber), mis-codification (use of incorrect physician ID, given recent introduction of new identifiers for laboratory results). Sometimes other physicians will copy colleagues as a professional courtesy (e.g., copying results of a family member); a practice that is no longer acceptable.

Solution: The Connect Care In-Basket has a "QuickActions" tool that allows prescribers to manage results received in error.

Select (click on) the In-Basket result notification and then look to the button bar at the top of the result display. The "QuickActions" pick-list is in the left-most position. There are two options:
  1. Not My Patient - if the result relates to a patient outside one's circle of care (as above).
  2. Not My Result - if the result relates to a patient that the receiving provider has had a care relationship with (in the circle of care) but the result should not have been routed to the Connect Care In-Basket (e.g., inpatient test result or otherwise should have been directed to a more responsible provider).
Clicking on either option will cause the In-Basket message to disappear. Medical records staff receive a notification so that a correction can be put in place and future mis-direction can be prevented. In addition, the physician is protected because privacy audits will take note and document that the physician did not review clinical material for a patient outside one's circle of care. 

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