title: Are amended surgical pathology reports getting to the correct responsible care provider?
abstract: OBJECTIVE
  Amended reports (AmRs) need to follow patients to treating physicians, to avoid erroneous management based on the original diagnosis. This study was undertaken to determine if AmRs followed the patient appropriately.
  
  
  METHODS
  AmRs with diagnostic changes and discrepancies between ordering and treating physicians were tracked. Chart reviews, electronic medical report (EMR) reviews, and interviews were conducted to establish receipt of the AmR by the correct physician.
  
  
  RESULTS
  Seven of 60 AmRs had discrepancies between the ordering and treating physicians, all with malignant diagnoses. The AmR was present in the treating physician's chart in only one case. Ordering physicians indicated that AmRs were not forwarded to treating physicians when corrected results arrived after patient referral, under the assumption that the new physician was automatically forwarded pathology updates. No harm was documented in any of our cases. In one case with a significant amendment, the correct information was entered in the patient chart based on a tumor board discussion. A review of two electronic health record systems uncovered significant shortcomings in each delivery system.
  
  
  CONCLUSIONS
  AmRs fail to follow the patient's chain of referrals to the correct care provider, and EMR systems lack the functionality to address this failure and alert clinical teams of amendments.
authors.affiliation: From the Department of Pathology, Yale University School of Medicine, New Haven, CT; Department of Pathology, Bridgeport Hospital, Bridgeport, CT.
authors.forename: Vinita
authors.initials: V
authors.lastname: Parkash
authors.affiliation: From the Department of Pathology, Yale University School of Medicine, New Haven, CT; Department of Pathology, Bridgeport Hospital, Bridgeport, CT.
authors.forename: Akosua
authors.initials: A
authors.lastname: Domfeh
authors.affiliation: From the Department of Pathology, Yale University School of Medicine, New Haven, CT; Department of Pathology, Bridgeport Hospital, Bridgeport, CT.
authors.forename: Paul
authors.initials: P
authors.lastname: Cohen
authors.affiliation: Oncology Associates of Bridgeport, Bridgeport, CT; and.
authors.forename: Neal
authors.initials: N
authors.lastname: Fischbach
authors.affiliation: Norma F. Pfriem Breast Care Center and.
authors.forename: Mary
authors.initials: M
authors.lastname: Pronovost
authors.affiliation: From the Department of Pathology, Yale University School of Medicine, New Haven, CT;
authors.forename: G Kenneth
authors.initials: GK
authors.lastname: Haines
authors.affiliation: From the Department of Pathology, Yale University School of Medicine, New Haven, CT;
authors.forename: Peter
authors.initials: P
authors.lastname: Gershkovich
mesh_terms: D057286:Electronic Health Records; D006801:Humans; D008499:Medical Records; D010340:Pathology, Surgical; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation
keywords: Amended; Reports; Surgical pathology