Do electronic medical records increase physician communication of critical test results to patients?

Originally posted in Insidermedicine

Advanced electronic systems that alert physicians when outpatients receive critical abnormal test results do not appear to reduce the rate at which these results are overlooked, according to research published in the latest issue of the Archives of Internal Medicine.

Here are some ways you can ensure that abnormal results of medical testing that you undergo are never overlooked, from U.S News & World Report:

• Always call your physician to ask about the results of any tests you undergo
• If you do not receive a reply to phone calls about test results, switch doctors
• Don’t assume that the presence of electronic medical records will safeguard you against important missed test results

Researchers from the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston studied the impact of an electronic records system that included a feature in which electronic alerts were sent to physicians whenever an outpatient in the hospital had “critical” abnormal findings on an imaging test. The researchers also reviewed medical records and contacted physicians to find out how these alerts were followed-up.

Of the nearly 125,000 imaging tests that were conducted during the study period, just under 1% produced abnormal findings critical enough to generate automatic alerts to physicians. Fully 18% of these alerts were never acknowledged by the doctors they were sent to, meaning electronic tracking systems indicated that they did not appear to have opened the message. Alerts were more likely to remain unopened if the recipients were trainees and if a dual-alert, rather than a single-alert system was in place. Nearly 8% of alerts were not followed-up in a timely fashion, whether they were opened or not. This lack of follow-up usually had a direct impact on patient care. Follow-up was more likely to occur if the individuals who conducted the test actually spoke to the physician responsible for the patient.

Today’s research suggests that electronic alert systems do not help reduce the rate with which critical abnormal test results are overlooked among hospital outpatients.