J Am Med Inform Assoc - Primary care practitioners' views on test result management in EHR-enabled health systems: a national survey.

Tópicos

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Resumo

NTEXT: Failure to notify patients of test results is common even when electronic health records (EHRs) are used to report results to practitioners. We sought to understand the broad range of social and technical factors that affect test result management in an integrated EHR-based health system.METHODS: Between June and November 2010, we conducted a cross-sectional, web-based survey of all primary care practitioners (PCPs) within the Department of Veterans Affairs nationwide. Survey development was guided by a socio-technical model describing multiple inter-related dimensions of EHR use.FINDINGS: Of 5001 PCPs invited, 2590 (51.8%) responded. 55.5% believed that the EHRs did not have convenient features for notifying patients of test results. Over a third (37.9%) reported having staff support needed for notifying patients of test results. Many relied on the patient's next visit to notify them for normal (46.1%) and abnormal results (20.1%). Only 45.7% reported receiving adequate training on using the EHR notification system and 35.1% reported having an assigned contact for technical assistance with the EHR; most received help from colleagues (60.4%). A majority (85.6%) stayed after hours or came in on weekends to address notifications; less than a third reported receiving protected time (30.1%). PCPs strongly endorsed several new features to improve test result management, including better tracking and visualization of result notifications.CONCLUSIONS: Despite an advanced EHR, both social and technical challenges exist in ensuring notification of test results to practitioners and patients. Current EHR technology requires significant improvement in order to avoid similar challenges elsewhere.

Resumo Limpo

ntext failur notifi patient test result common even electron health record ehr use report result practition sought understand broad rang social technic factor affect test result manag integr ehrbas health systemmethod june novemb conduct crosssect webbas survey primari care practition pcps within depart veteran affair nationwid survey develop guid sociotechn model describ multipl interrel dimens ehr usefind pcps invit respond believ ehr conveni featur notifi patient test result third report staff support need notifi patient test result mani reli patient next visit notifi normal abnorm result report receiv adequ train use ehr notif system report assign contact technic assist ehr receiv help colleagu major stay hour came weekend address notif less third report receiv protect time pcps strong endors sever new featur improv test result manag includ better track visual result notificationsconclus despit advanc ehr social technic challeng exist ensur notif test result practition patient current ehr technolog requir signific improv order avoid similar challeng elsewher

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