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LMOM—What It Means for Patient Satisfaction and Risk

Let's consider the term "LMOM," which means "left message on machine" since many still use it to document patient follow-up calls.

The use of this phrase begs the question: What message was left on the machine? Did the message include the reason for the call? Was the patient asked to return the call? Were instructions provided? Was the call just a follow up to the last visit? When the patient returns the call, what happens if the person who left the message is out? Does the patient need to call back? Will others have sufficient information to return the call?

A good rule of thumb of defensible documentation is to document at one level higher than you think is necessary. Therefore, if you or your staff use the abbreviation LMOM, consider documenting one level higher. This means summarizing the message and the reason for the call. 

I recently talked with someone who told me she always documented so that if she died tonight, anyone who read her notes would know her exact intentions. That’s a little morbid, but it works. 

Example

When she documents “LMOM,” she also notes she “asked patient to return the call” and signs it with her name and credentials. This is followed by a brief summary of the call and why she placed it. For example: “Called patient to advise that Dr. G reviewed the test results and the levels were within normal range. Dr. G said to follow up as planned.” Consequently, if the patient returns the call when she is out of the office, the person who answers the call will have enough information to share the intended message with the patient. 

Although answering machines are fading out of use, that is not the case with voicemail. As with answering machine messages, voicemail messages are subject to HIPAA privacy rules. This means that a patient’s privacy should be “reasonably safeguarded.” Therefore, it is important to use care with what is disclosed on voicemail messages. 

Consider using the same criteria for voicemail and answering machine messages. The message should identify the caller, practice name and return call number. You can add whether the message is urgent or not.

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