通知政策对即时发布的检验结果的患者先于临床医生查阅的影响。
Impact of notification policy on patient-before-clinician review of immediately released test results.
机构信息
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
出版信息
J Am Med Inform Assoc. 2023 Sep 25;30(10):1707-1710. doi: 10.1093/jamia/ocad126.
The 21st Century Cures Act mandates immediate availability of test results upon request. The Cures Act does not require that patients be informed of results, but many organizations send notifications when results become available. Our medical center implemented 2 sequential policies: immediate notifications for all results, and notifications only to patients who opt in. We used over 2 years of data from Vanderbilt University Medical Center to measure the effect of these policies on rates of patient-before-clinician result review and patient-initiated messaging using interrupted time series analysis. When releasing test results with immediate notification, the proportion of patient-before-clinician review increased 4-fold and the proportion of patients who sent messages rose 3%. After transition to opt-in notifications, patient-before-clinician review decreased 2.4% and patient-initiated messaging decreased 0.4%. Replacing automated notifications with an opt-in policy provides patients flexibility to indicate their preferences but may not substantially alleviate clinicians' messaging workload.
《21 世纪治愈法案》要求在患者提出请求时立即提供检测结果。该法案并未要求通知患者检测结果，但许多机构在结果可用时会发送通知。我们的医疗中心实施了 2 项连续政策：对所有结果立即通知，并且仅向选择加入的患者通知。我们使用范德比尔特大学医学中心超过 2 年的数据，使用中断时间序列分析来衡量这些政策对患者在临床医生之前查看结果和患者发起消息的比例的影响。当使用即时通知发布检测结果时，患者在临床医生之前查看结果的比例增加了 4 倍，发送消息的患者比例增加了 3%。过渡到选择加入通知后，患者在临床医生之前查看结果的比例下降了 2.4%，患者发起的消息数量下降了 0.4%。用选择加入政策代替自动通知为患者提供了表达偏好的灵活性，但可能不会大大减轻临床医生的消息处理工作量。
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