Understanding the management of electronic test result notifications in the outpatient setting.
Understanding the management of electronic test result notifications in the outpatient setting.
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DOI：
10.1186/1472-6947-11-22
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发表时间：
2011-04-12
影响因子：
3.5
通讯作者：
Singh H
中科院分区：
文献类型：
--
作者：
Hysong SJ;Sawhney MK;Wilson L;Sittig DF;Esquivel A;Singh S;Singh H
通过基于电子健康记录（EHR）的“警报”通知临床医生异常检测结果可能并不总是导致及时随访患者。我们试图了解通过电子警报安全有效地管理异常检测结果交付的障碍、促进因素和潜在干预措施。我们进行了一项定性研究，包括六个6-8成员焦点小组（N = 44）在两个大的，地理上分散的退伍军人事务设施。参与者包括全职初级保健提供者，以及代表诊断服务（放射学，实验室）和信息技术的人员。我们要求参与者讨论障碍、促进因素以及改进异常检测结果通知的及时管理和后续工作的建议，并鼓励他们考虑技术问题，以及EHR使用中更广泛的与人为因素相关的方面，如组织、人员和工作流程。提供者报告说收到了大量警报，其中包含与异常测试结果无关的信息，其中许多被认为是不必要的。一些供应商还报告说，他们缺乏使用某些EHR功能的熟练程度，这些功能将使他们能够更有效地管理警报。改进建议包括改进电子健康记录中关键警报的显示和跟踪流程，重新设计临床工作流程，以及简化与检测结果通知相关的政策和程序。供应商认识到故障安全电子通信和异常测试结果跟踪的几个挑战。一个多维度的方法，解决技术以及我们引出的许多非技术因素是必不可少的设计干预措施，以减少在电子健康档案遗漏的测试结果。
Notifying clinicians about abnormal test results through electronic health record (EHR) -based "alert" notifications may not always lead to timely follow-up of patients. We sought to understand barriers, facilitators, and potential interventions for safe and effective management of abnormal test result delivery via electronic alerts. We conducted a qualitative study consisting of six 6-8 member focus groups (N = 44) at two large, geographically dispersed Veterans Affairs facilities. Participants included full-time primary care providers, and personnel representing diagnostic services (radiology, laboratory) and information technology. We asked participants to discuss barriers, facilitators, and suggestions for improving timely management and follow-up of abnormal test result notifications and encouraged them to consider technological issues, as well as broader, human-factor-related aspects of EHR use such as organizational, personnel, and workflow. Providers reported receiving a large number of alerts containing information unrelated to abnormal test results, many of which were believed to be unnecessary. Some providers also reported lacking proficiency in use of certain EHR features that would enable them to manage alerts more efficiently. Suggestions for improvement included improving display and tracking processes for critical alerts in the EHR, redesigning clinical workflow, and streamlining policies and procedures related to test result notification. Providers perceive several challenges for fail-safe electronic communication and tracking of abnormal test results. A multi-dimensional approach that addresses technology as well as the many non-technological factors we elicited is essential to design interventions to reduce missed test results in EHRs.
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影响因子：
--
作者：
Poon, EG;Gandhi, TK;Bates, DW
通讯作者：
Bates, DW
影响因子：
--
作者：
Singh, Hardeep;Thomas, Eric J.;Petersen, Laura A.
通讯作者：
Petersen, Laura A.
影响因子：
4.5
作者：
Poon, EG;Wang, SJ;Kuperman, GJ
通讯作者：
Kuperman, GJ
影响因子：
5.9
作者：
Singh, Hardeep;Thomas, Eric J.;Petersen, Laura A.
通讯作者：
Petersen, Laura A.
影响因子：
--
作者：
Hickner, J.;Graham, D. G.;Phillips, R.
通讯作者：
Phillips, R.