BMC Med Inform Decis Mak - Understanding the management of electronic test result notifications in the outpatient setting.

Tópicos

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{ method(2212) result(1239) propos(1039) }

Resumo

CKGROUND: 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.

Resumo Limpo

ckground notifi clinician abnorm test result electron health record ehr base alert notif may alway lead time followup patient sought understand barrier facilit potenti intervent safe effect manag abnorm test result deliveri via electron alertsmethod conduct qualit studi consist six member focus group n two larg geograph dispers veteran affair facil particip includ fulltim primari care provid personnel repres diagnost servic radiolog laboratori inform technolog ask particip discuss barrier facilit suggest improv time manag followup abnorm test result notif encourag consid technolog issu well broader humanfactorrel aspect ehr use organiz personnel workflowresult provid report receiv larg number alert contain inform unrel abnorm test result mani believ unnecessari provid also report lack profici use certain ehr featur enabl manag alert effici suggest improv includ improv display track process critic alert ehr redesign clinic workflow streamlin polici procedur relat test result notificationconclus provid perceiv sever challeng failsaf electron communic track abnorm test result multidimension approach address technolog well mani nontechnolog factor elicit essenti design intervent reduc miss test result ehr

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