Physicians often fail to notify patients of test results, even when electronic health records seemingly make it easier to receive them, according to a recently published study in the Journal of the American Medical Informatics Association.
Failure to tell patients their test results, particularly abnormal test results, is a major safety concern. The researchers, from the Veteran's Administration Medical Center in Houston and elsewhere, conducted a survey of 2,590 primary care physicians nationally in the VA system to determine whether their EHR result notification system--called "View Alert"--helped them then transmit the information to their patients.
The researchers found significant challenges in getting the lab result information to the patients, even though the physicians were receiving the test results. Although more than 74 percent said that they had the knowledge, and close to 82 percent said they had the proficiency to use View Alert, roughly 55 percent believed that the EHRs didn't have convenient features to notify them of the test results. Many of them reported that they were bombarded by so many alerts that they missed the test results; many others received only notifications determined important by their facilities.
Other factors impeded the ability of the physicians to notify patients of test results, as well. Many doctors simply relied on the patient's next visit to communicate the results; in some facilities, it was unclear whether the physician or support staff was responsible for transmitting the results. Moreover, the EHRs seemed to increase the burden of such reporting, with 85.6 percent of respondents relating that they worked after hours and on weekends to deal with the notifications.
"[C]urrent capabilities for test result management are limited even within a well-established, mature EHR," the authors said. "A comprehensive socio-technical approach is needed to optimize EHR-based test result management."
The authors say that EHRs need to be better designed to easily retrieve test result alerts, and that better methods to display and sort the information to minimize alert related information overload and improve electronic hand-off should be made available. They also say that the systems should support electronic self-reminders to physicians so that they'll be more likely to follow up with patients.
Alert overload and poor EHR design have long been a sore point in clinical decision support and functionality. Other studies have revealed similar concerns that alerts impede workflow and add to physicians' burdens.
To learn more:
- here's the study