Pending lab tests are not in hospitalist discharge summaries

As hospitalist programs become more prevalent, the issue of how best to communicate discharge summaries and instructions to primary care physicians remains.

A recent study suggested that only 16% of pending lab tests were written in hospitalist discharge summaries, which is a staggeringly low number.

Doctors who see hospitalized patients in follow-up need to know what they’re looking for; whether it’s abnormal potassium level or the result of an imaging study that hasn’t been read yet.

According to the study’s lead author, “it’s a problem that’s being exacerbated by the growth of hospital medicine for two reasons: More and more patients are seen by separate inpatient and outpatient physicians, and sicker patients are being discharged sooner from hospitals.”

An obvious solution would be unified electronic medical records, where primary care doctors can easily look up results during a post-hospitalization visit. But that’s currently a fantasy. My clinic, for instance, uses a different electronic system than the two local hospitals, both of which uses different systems from each other.

And that’s not even considering the increasing number of patients who simply don’t have primary care doctors to follow-up with.

Some hospitals have post-discharge clinics where hospitalists do the follow-up themselves, but that’s not commonplace. We clearly have a ways to go in bridging  the communication gap between hospitalist and outpatient physician.

(via David Williams)

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