Physicians who receive electronic alerts about abnormal test results fail to follow up with patients in nearly 8% of cases, according to a study published Monday in the Archives of Internal Medicine, HealthDay/U.S. News & World Report reports (HealthDay/U.S. News & World Report, 9/28).
For the study, researchers examined imaging test results at a Veterans Affairs outpatient medical center from November 2007 to June 2008.
The study identified 1,196 electronic alerts about abnormal test results. Of the alerts:
- 92, or 7.7%, did not receive a response within four weeks; and
- 217, or 18.1%, remained unopened after two weeks.
Researchers found that follow-up rates were similar for both opened and unopened alerts.
They also found that physicians were less likely to respond to alerts if more than one physician received the notification.
Physicians were more likely to follow up if a radiologist called a physician about the test results (Mestel, "Booster Shots," Los Angeles Times, 9/28).
In nearly all of the cases, a lack of timely follow-up care caused patient conditions to worsen (Steenhuysen, Reuters, 9/28).
Implications
The study demonstrates that electronic health record systems do not eliminate the need to account for human error, the researchers said.
However, they noted that EHRs still offer significant benefits over paper-based models (Ackerman, Houston Chronicle, 9/29).
Recommendations
To improve physician response to electronic alerts, the researchers recommend:
- Developing clear guidelines about which physician should follow up with a patient;
- Reducing information overload for physicians;
- Requiring alerts to remain on a physician's computer for a longer period of time; and
- Tracking whether follow up action occurs ("Booster Shots," Los Angeles Times, 9/28).