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肝脏成像结果发布的时间与肝硬化患者在医生之前查看结果有关。

Timing of Liver Imaging Result Release Is Associated with Patients with Cirrhosis Reviewing Results Prior to Providers.

作者信息

Louissaint Jeremy, Deng John, Tapper Elliot B, Turer Robert W, Hogan Timothy P, Yekkaluri Sruthi, Dunn Patrick, Singal Amit G

机构信息

Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, United States.

Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, United States.

出版信息

Appl Clin Inform. 2025 Mar;16(2):345-349. doi: 10.1055/a-2494-1722. Epub 2025 Apr 16.

Abstract

BACKGROUND

Patients with cirrhosis are at high risk for developing hepatocellular carcinoma (HCC), warranting receipt of semiannual surveillance imaging with the potential to identify abnormal liver lesions. Since the implementation of the 21st Century Cures Act's Information Blocking provision, test results are immediately released to patients through the patient portal. There is an increasing trend of patients reviewing their results before their providers.

OBJECTIVE

We aimed to determine whether the date and time characteristics of when the result is released to the electronic health record (EHR) are associated with patients reviewing results before providers.

METHODS

In patients with cirrhosis undergoing ambulatory liver imaging, the date-time characteristics of when the result was released to providers in the EHR were categorized as outside regular work hours for holidays, weekends, or outside normal business hours. Logistic regression was used to determine the relationship between results released to the EHR outside work hours and whether the patient or provider was the first to review the result.

RESULTS

We identified 850 imaging studies from 401 patients with a median age of 62 (interquartile range [IQR]: 53-69) years. Patient time to result review was shorter or equivalent to their providers for 57% of the results. A total of 170 (20.0%) of results were released outside regular work hours. There was an increased odds of the patient reviewing the result before providers for results released outside regular work hours (adjusted odds ratio [aOR] = 1.54, 95% CI: 1.08-2.20).

CONCLUSION

HCC screening results released to the EHR outside regular work hours is associated with patients reviewing these results before providers.

摘要

背景

肝硬化患者发生肝细胞癌(HCC)的风险很高,因此需要每半年进行一次监测成像,以便发现肝脏异常病变。自《21世纪治愈法案》的信息封锁条款实施以来,检测结果会立即通过患者门户发布给患者。患者在医生之前查看检测结果的趋势日益增加。

目的

我们旨在确定检测结果发布到电子健康记录(EHR)的日期和时间特征是否与患者在医生之前查看结果有关。

方法

在接受门诊肝脏成像的肝硬化患者中,将检测结果在EHR中发布给医生的日期时间特征分类为节假日、周末的非工作时间或正常工作时间以外。采用逻辑回归分析来确定在非工作时间发布到EHR的结果与患者或医生谁先查看结果之间的关系。

结果

我们纳入了401例患者的850项成像研究,患者的中位年龄为62岁(四分位间距[IQR]:53 - 69岁)。57%的结果显示患者查看结果的时间比医生短或相同。共有170项(20.0%)结果在正常工作时间以外发布。对于在正常工作时间以外发布的结果,患者在医生之前查看结果的几率增加(调整后的优势比[aOR]=1.54,95%置信区间:1.08 - 2.20)。

结论

在正常工作时间以外发布到EHR的HCC筛查结果与患者在医生之前查看这些结果有关。

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