Can information technology improve test result follow-up?

Joanne Callen, Richard Paoloni, Mirela Prgomet, Andrew Georgiou, Louise Robertson, Johanna Westbrook

Research output: Chapter in Book/Report/Conference proceedingConference proceeding contribution

Abstract

Background: Delays and failure to follow-up abnormal test results after a patient leaves hospital are critical patient safety issues which have not been comprehensively studied.
Aim: To explore the non-endorsement of test results in a metropolitan teaching hospital Emergency Department
Research questions:
1) What is the average time between microbiology and radiology test ordering and clinician endorsement?
2) What proportions of microbiology and radiology test results were not endorsed?
Methods: The study was conducted in the Emergency Department (ED) of a 400-bed hospital which has used a computerised provider order entry (CPOE) system to order and view diagnostic and radiology tests for all inpatients since 1992. Data relating to microbiology (n=126) and radiology tests (n=240) ordered by ED physicians were collected for a five day period (13th-17th August 2007). Comparisons were made between the CPOE generated list of tests ordered and the endorsement of test results on hard copy reports printed to the ED. The medical records of patients where the microbiology or radiology test appeared on the test order list but were missing from the test results printed to the ED were reviewed.
Results: The average duration between the time a specimen was collected or an examination was performed and a result report was printed to the ED was 2.5 days for microbiology and 1.5 days for radiology with the majority (64% and 93% respectively) endorsed on the same day the result was printed. The majority of microbiology and radiology results were printed within two days of specimen collection or examination (68%; n=163 and 68%; n=85 respectively). Two microbiology results and seven radiology reports appeared not to have been
endorsed. The patients’ medical records for these 9 results were reviewed by an ED clinician (RP). After review there was no evidence that the two microbiology results were endorsed (1.6%) nor that two of the radiology reports were endorsed (0.8%) either prior or post patient discharge.
Conclusion: This study highlighted the need for the test endorsement function to be utilized in the existing CPOE system to assist clinicians in following up all test results for their patients.
Original languageEnglish
Title of host publicationHIC 2008 Conference
Subtitle of host publicationAustralias Health Informatics Conference; The Person in the Centre
EditorsHeather Grain
PublisherHealth Informatics Society of Australia (HISA)
Pages66-71
Number of pages6
ISBN (Print)9780980552003
Publication statusPublished - 2008
Externally publishedYes
EventHIC 2008 Conference: Australias Health Informatics Conference; The Person in the Centre - Melbourne, Australia
Duration: 31 Aug 20082 Sep 2008

Conference

ConferenceHIC 2008 Conference
CountryAustralia
CityMelbourne
Period31/08/082/09/08

Keywords

  • Diagnostic tests
  • computerized physician order entry systems
  • CPOE
  • safety
  • hospital information systems

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  • Cite this

    Callen, J., Paoloni, R., Prgomet, M., Georgiou, A., Robertson, L., & Westbrook, J. (2008). Can information technology improve test result follow-up? In H. Grain (Ed.), HIC 2008 Conference: Australias Health Informatics Conference; The Person in the Centre (pp. 66-71). Health Informatics Society of Australia (HISA).