Sharing electronic laboratory results in a patient portal--a feasibility pilot.
ABSTRACT Surveys of patients consistently demonstrate a very strong interest in having secure electronic access to their own laboratory test results. In recent years, a number of health care providers and lab service centers have offered this capability, which now extends to millions of patients in the United States. Yet, little has been published on the methods of making lab results available. This case report identifies the objectives, methods, and results of a feasibility pilot conducted at Partners Healthcare from May to September, 2006. A candidate set of results were identified, approved for release, programmed into Patient Gateway, Partners' secure patient portal, and studied. Patient and practice feedback was positive. No noticeable rise in patient concerns was observed by practice staff or through patient surveys. One-half of patients who viewed results accessed reference information linked to a result. Organizational and practice-level issues necessary to support continued rollout are described.
- SourceAvailable from: Jennie J. Gallimore
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- "An essential part of primary care, patient testing must be managed well to achieve the right care in the right time, amount, site, and setting with the right information and personnel in the right specialty (Hickner et al., 2005; Wakefield, Ward, & Wakefield, 2007). Non-standardized testing management decreases patient safety; increases clinician workload, costs, and delays; and worsens clinical outcomes (Battaglia et al., 2010; Schiff et al., 2009; H. Singh et al., 2009b; Wahls & Peleg, 2009; Wald et al., 2007). This research is focused on answering the test tracking and safety needs identified by a study of testing management practices in four Southwest Ohio primary care offices (Elder, McEwen, Flach, & Gallimore, 2009). "
ABSTRACT: As a gateway to specialty care, primary care relies on patient testing—including laboratory work and imaging—for many kinds of patient diagnoses and treatments. Because of this, patient safety can be adversely affected when testing orders are not tracked, results are lost, or patients are not notified of results. Non-standardized testing management also worsens clinical outcomes, lessens system resilience, and increases clinician workload, costs, and delays. During development of a system to better support patient test tracking, a survey was performed to assess perceptions, attitudes, and actions of current healthcare practitioners. Responses from 261 people show a variety of experience with the phrase "no news is good news" for testing results, attitudes and reactions about health technology, perceptions of usefulness and time consumption of safety-related actions, and failures and successes observed throughout testing management processes.
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- "i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s x x x ( 2 0 1 2 ) xxx–xxx 3 the service . Patients were satisfied when offered a secure patient portal to view their laboratory test results; and over half of the patients also accessed related reference information and there was no noticeable increase in patient concerns associated with knowing test results . Research conducted by Poon et al. found that care and communication provided via a personal health record has been well accepted by both patients and providers . "
ABSTRACT: Patients and health care providers often lack real time access to information at the bedside required to provide safe patient-centered care. Both groups identified pertinent information needed at the patient's bedside. The purpose of our research was to identify the essential data elements that will be used to define requirements for a useful bedside communication tool in the acute care hospital setting. Descriptive research methods were used to identify bedside information requirements through group and individual interviews. Data from patients and health care providers were analyzed to identify common themes, compiled into a survey, and validated by both groups. Thirty-seven information requirements were identified and classified under five themes: (1) plan of care, (2) patient education, (3) communication of safety alerts, (4) diet, and (5) medications. A survey completed by 30 patients and 30 health care providers confirmed 36 specific bedside information requirements (mean ≥ 5 on an 11-point scale). Patients and health providers each identified 24 specific information requirements that were similar in importance. When compared with nurses, significant differences were noted in the degree to which patients identified knowing the "daily routine schedule," e.g. when their doctor typically sees patients as a key requirement for the electronic bedside communication tool, t=3.52, p=.001. Patients and health care providers identified information requirements at the bedside to promote self-care management of healthcare needs and an understanding of the hospital environment. Accurate, easily accessed information at the bedside is needed for providing safe patient-centered care.International Journal of Medical Informatics 01/2012; 81(7):442-51. DOI:10.1016/j.ijmedinf.2011.12.005 · 2.72 Impact Factor
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ABSTRACT: Failing to inform a patient of an abnormal outpatient test result can be a serious error, but little is known about the frequency of such errors or the processes for managing results that may reduce errors. We conducted a retrospective medical record review of 5434 randomly selected patients aged 50 to 69 years in 19 community-based and 4 academic medical center primary care practices. Primary care practice physicians were surveyed about their processes for managing test results, and individual physicians were notified of apparent failures to inform and asked whether they had informed the patient. Blinded reviewers calculated a "process score" ranging from 0 to 5 for each practice using survey responses. The rate of apparent failures to inform or to document informing the patient was 7.1% (135 failures divided by 1889 abnormal results), with a range of 0% to 26.2%. The mean process score was 3.8 (range, 0.9-5.0). In mixed-effects logistic regression, higher process scores were associated with lower failure rates (odds ratio, 0.68; P < .001). Use of a "partial electronic medical record" (paper-based progress notes and electronic test results or vice versa) was associated with higher failure rates compared with not having an electronic medical record (odds ratio, 1.92; P = .03) or with having an electronic medical record that included both progress notes and test results (odds ratio, 2.37; P = .007). Failures to inform patients or to document informing patients of abnormal outpatient test results are common; use of simple processes for managing results is associated with lower failure rates.Archives of internal medicine 06/2009; 169(12):1123-9. DOI:10.1001/archinternmed.2009.130 · 13.25 Impact Factor