Dalal Anuj K, Pesterev Bailey M, Eibensteiner Katyuska, Newmark Lisa P, Samal Lipika, Rothschild Jeffrey M
Division of General Medicine and Primary Care, Brigham and Women's Hospital
Division of General Medicine and Primary Care, Brigham and Women's Hospital.
J Am Med Inform Assoc. 2015 Jul;22(4):905-8. doi: 10.1093/jamia/ocv007. Epub 2015 Mar 21.
Failure to follow-up nonurgent, clinically significant test results (CSTRs) is an ambulatory patient safety concern. Tools within electronic health records (EHRs) may facilitate test result acknowledgment, but their utility with regard to nonurgent CSTRs is unclear. We measured use of an acknowledgment tool by 146 primary care physicians (PCPs) at 13 network-affiliated practices that use the same EHR. We then surveyed PCPs to assess use of, satisfaction with, and desired enhancements to the acknowledgment tool. The rate of acknowledgment of non-urgent CSTRs by PCPs was 78%. Of 73 survey respondents, 72 reported taking one or more actions after reviewing a CSTR; fewer (40-75%) reported that using the acknowledgment tool was helpful for a specific purpose. Forty-six (64%) were satisfied with the tool. Both satisfied and nonsatisfied PCPs reported that enhancements linking acknowledgment to routine actions would be useful. EHR vendors should consider enhancements to acknowledgment functionality to ensure follow-up of nonurgent CSTRs.
未能对非紧急但具有临床意义的检查结果（CSTRs）进行随访是门诊患者安全的一个问题。电子健康记录（EHRs）中的工具可能有助于确认检查结果，但它们在非紧急CSTRs方面的效用尚不清楚。我们在13个使用相同EHR的网络附属医疗机构中，对146名初级保健医生（PCPs）使用确认工具的情况进行了测量。然后，我们对PCPs进行了调查，以评估确认工具的使用情况、满意度以及期望的改进之处。PCPs对非紧急CSTRs的确认率为78%。在73名调查受访者中，72人报告在查看CSTR后采取了一项或多项行动；较少比例（40%-75%）的人报告使用确认工具对特定目的有帮助。46人（64%）对该工具感到满意。满意和不满意的PCPs都报告说，将确认与常规行动联系起来的改进会很有用。EHR供应商应考虑增强确认功能，以确保对非紧急CSTRs进行随访。
