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Understanding the management of electronic test result notifications in the outpatient setting

BACKGROUND: Notifying clinicians about abnormal test results through electronic health record (EHR) -based "alert" notifications may not always lead to timely follow-up of patients. We sought to understand barriers, facilitators, and potential interventions for safe and effective managemen...

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Autores principales: Hysong, Sylvia J, Sawhney, Mona K, Wilson, Lindsey, Sittig, Dean F, Esquivel, Adol, Singh, Simran, Singh, Hardeep
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100236/
https://www.ncbi.nlm.nih.gov/pubmed/21486478
http://dx.doi.org/10.1186/1472-6947-11-22
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author Hysong, Sylvia J
Sawhney, Mona K
Wilson, Lindsey
Sittig, Dean F
Esquivel, Adol
Singh, Simran
Singh, Hardeep
author_facet Hysong, Sylvia J
Sawhney, Mona K
Wilson, Lindsey
Sittig, Dean F
Esquivel, Adol
Singh, Simran
Singh, Hardeep
author_sort Hysong, Sylvia J
collection PubMed
description BACKGROUND: Notifying clinicians about abnormal test results through electronic health record (EHR) -based "alert" notifications may not always lead to timely follow-up of patients. We sought to understand barriers, facilitators, and potential interventions for safe and effective management of abnormal test result delivery via electronic alerts. METHODS: We conducted a qualitative study consisting of six 6-8 member focus groups (N = 44) at two large, geographically dispersed Veterans Affairs facilities. Participants included full-time primary care providers, and personnel representing diagnostic services (radiology, laboratory) and information technology. We asked participants to discuss barriers, facilitators, and suggestions for improving timely management and follow-up of abnormal test result notifications and encouraged them to consider technological issues, as well as broader, human-factor-related aspects of EHR use such as organizational, personnel, and workflow. RESULTS: Providers reported receiving a large number of alerts containing information unrelated to abnormal test results, many of which were believed to be unnecessary. Some providers also reported lacking proficiency in use of certain EHR features that would enable them to manage alerts more efficiently. Suggestions for improvement included improving display and tracking processes for critical alerts in the EHR, redesigning clinical workflow, and streamlining policies and procedures related to test result notification. CONCLUSION: Providers perceive several challenges for fail-safe electronic communication and tracking of abnormal test results. A multi-dimensional approach that addresses technology as well as the many non-technological factors we elicited is essential to design interventions to reduce missed test results in EHRs.
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spelling pubmed-31002362011-05-24 Understanding the management of electronic test result notifications in the outpatient setting Hysong, Sylvia J Sawhney, Mona K Wilson, Lindsey Sittig, Dean F Esquivel, Adol Singh, Simran Singh, Hardeep BMC Med Inform Decis Mak Research Article BACKGROUND: Notifying clinicians about abnormal test results through electronic health record (EHR) -based "alert" notifications may not always lead to timely follow-up of patients. We sought to understand barriers, facilitators, and potential interventions for safe and effective management of abnormal test result delivery via electronic alerts. METHODS: We conducted a qualitative study consisting of six 6-8 member focus groups (N = 44) at two large, geographically dispersed Veterans Affairs facilities. Participants included full-time primary care providers, and personnel representing diagnostic services (radiology, laboratory) and information technology. We asked participants to discuss barriers, facilitators, and suggestions for improving timely management and follow-up of abnormal test result notifications and encouraged them to consider technological issues, as well as broader, human-factor-related aspects of EHR use such as organizational, personnel, and workflow. RESULTS: Providers reported receiving a large number of alerts containing information unrelated to abnormal test results, many of which were believed to be unnecessary. Some providers also reported lacking proficiency in use of certain EHR features that would enable them to manage alerts more efficiently. Suggestions for improvement included improving display and tracking processes for critical alerts in the EHR, redesigning clinical workflow, and streamlining policies and procedures related to test result notification. CONCLUSION: Providers perceive several challenges for fail-safe electronic communication and tracking of abnormal test results. A multi-dimensional approach that addresses technology as well as the many non-technological factors we elicited is essential to design interventions to reduce missed test results in EHRs. BioMed Central 2011-04-12 /pmc/articles/PMC3100236/ /pubmed/21486478 http://dx.doi.org/10.1186/1472-6947-11-22 Text en Copyright ©2011 Hysong et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Hysong, Sylvia J
Sawhney, Mona K
Wilson, Lindsey
Sittig, Dean F
Esquivel, Adol
Singh, Simran
Singh, Hardeep
Understanding the management of electronic test result notifications in the outpatient setting
title Understanding the management of electronic test result notifications in the outpatient setting
title_full Understanding the management of electronic test result notifications in the outpatient setting
title_fullStr Understanding the management of electronic test result notifications in the outpatient setting
title_full_unstemmed Understanding the management of electronic test result notifications in the outpatient setting
title_short Understanding the management of electronic test result notifications in the outpatient setting
title_sort understanding the management of electronic test result notifications in the outpatient setting
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100236/
https://www.ncbi.nlm.nih.gov/pubmed/21486478
http://dx.doi.org/10.1186/1472-6947-11-22
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