Primary care physician attitudes concerning follow-up of abnormal test results and ambulatory decision support systems
ABSTRACT Failures to follow-up abnormal test results are common in ambulatory care. Information systems could assist providers with abnormal test result tracking, yet little is known about primary care providers attitudes toward outpatient decision support systems.
A cross-sectional survey of 216 primary care physicians (PCPs) that utilize a single electronic medical record (EMR) without computer-based clinical decision support.
The overall response rate was 65% (140/216). Less than one-third of the respondents were satisfied with their current system to manage abnormal laboratory, radiographs, Pap smear, or mammograms results. Only 15% of providers were satisfied with their system to notify patients of abnormal results. Over 90% of respondents felt automated systems to track abnormal test results would be useful. Seventy-nine percent of our respondents believed that they could comply better with guidelines through electronic clinical reminders.
Most PCPs were not satisfied with their methods for tracking abnormal results. Respondents believed that clinical decision support systems (CDSS) would be useful and could improve their ability to track abnormal results.
- SourceAvailable from: David W Bates
[Show abstract] [Hide abstract]
- "When test results are not acted on in a timely and appropriate manner, patientsÕ safety and satisfaction are jeopardized . Prior research has shown that both patients  and physicians  are concerned with this issue, and results from other studies     further highlight the ongoing need to address this gap in quality. Moreover, this issue is beginning to receive more national attention. "
ABSTRACT: Prior research has demonstrated that clinicians often fail to review and act upon outpatient test results in a timely and appropriate manner. To address this patient safety and quality of care issue, Partners Healthcare has developed a browser-based, provider-centric, comprehensive results management application to help clinic physicians review and act upon test results in a safe, reliable, and efficient manner. The application, called the Results Manager, incorporates extensive decision support features to classify the degree of abnormality for each result, presents guidelines to help clinicians manage abnormal results, allows clinicians to generate result letters to patients with predefined, context-sensitive templates and prompts physicians to set reminders for future testing. In this paper, we outline the design process and functionality of Results Manager. We also discuss its underlying architectural design, which revolves around a clinical event monitor and a rules engine, and the methodological challenges encountered in designing this application.Journal of Biomedical Informatics 02/2003; 36(1-2):80-91. DOI:10.1016/S1532-0464(03)00061-3 · 2.48 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Diagnostic errors are an important and often underappreciated source of medical error, needless delays to treatment, and needlessly wasted resources. Almost 65% of diagnostic errors have an important contribution of system errors, of which many are an abnormal test result that was lost to follow-up, that is, missed results. These system problems that contribute to missed results may represent low-hanging fruit for those who wish to reduce diagnostic errors in their institution. The rate of missed results and associated treatment delay are discussed. The system factors and human factors that contribute to these errors are discussed along with strategies that can be adopted to reduce these errors.The Journal of ambulatory care management 01/2007; 30(4):338-43. DOI:10.1097/01.JAC.0000290402.89284.a9
- [Show abstract] [Hide abstract]
ABSTRACT: This study was conducted to evaluate the hospital information system (HIS) software based on user requirements in Iran. Through a descriptive study 5 vendors which had the best selling software products among the university hospitals were selected. HIS softwares were evaluated based on checklist and through the observation in 8 hospitals according to defined criteria. SPSS and descriptive statistics were employed to analyze the collected data. Maximum user's expectations were supported by Tarrahan Boali. However, Tarrahan Bali has not efficiently met user expectations in all departments; medical records (74.5%), pharmacy (58.6%), laboratory (74.5%), nursing (23.3%), radiology (51.4%) and financial (65.4%). Minimum user requirements (29%) have been met by Microafzar Qeshm. There was no HIS software to meet the end users expectations in all departments completely. Failure to meet the user expectations among software that addresses all user expectations appropriately could be ascribed to poor user participation and revealed that HIS adoption in Iran is still in infancy. Conducting periodical evaluation; employing a comprehensive tool for HIS evaluation is crucial to ensure their effective implementation and improvement.05/2011; 5(1).