Study Finds Emailing Providers Increases Awareness of Pending Test Results
Many patients have pending test results at the time of hospital discharge, and lack of appropriate follow-up on those results may pose a risk to a patient’s safety, according to a new AHRQ-funded study. Hospitals that automatically emailed physicians test results when they became available increased provider awareness of actionable test results, according to AHRQ-supported research that appeared October 23 in the Journal of the American Medical Informatics Association. According to the journal article and abstract, titled “Impact of an Automated Email Notification System for Results of Tests Pending at Discharge: A Cluster Randomized Controlled Trial,” providers who received the emails were significantly more likely to be aware of abnormal test results, suggesting that widespread use of such notifications could improve patient safety. The study examined the impact of automatically emailing test results that were pending at the time of discharge to both the hospital attending physician and the patient’s primary care provider.
J Am Med Inform Assoc. 2013 Oct 23. doi: 10.1136/amiajnl-2013-002030. [Epub ahead of print]
Impact of an automated email notification system for results of tests pending at discharge: a cluster-randomized controlled trial.
Dalal AK, Roy CL, Poon EG, Williams DH, Nolido N, Yoon C, Budris J, Gandhi T, Bates DW, Schnipper JL.
BACKGROUND AND OBJECTIVE:
Physician awareness of the results of tests pending at discharge (TPADs) is poor. We developed an automated system that notifies responsible physicians of TPAD results via secure, network email. We sought to evaluate the impact of this system on self-reported awareness of TPAD results by responsible physicians, a necessary intermediary step to improve management of TPAD results.
We conducted a cluster-randomized controlled trial at a major hospital affiliated with an integrated healthcare delivery network in Boston, Massachusetts. Adult patients with TPADs who were discharged from inpatient general medicine and cardiology services were assigned to the intervention or usual care arm if their inpatient attending physician and primary care physician (PCP) were both randomized to the same study arm. Patients of physicians randomized to discordant study arms were excluded. We surveyed these physicians 72 h after all TPAD results were finalized. The primary outcome was awareness of TPAD results by attending physicians. Secondary outcomes included awareness of TPAD results by PCPs, awareness of actionable TPAD results, and provider satisfaction.
We analyzed data on 441 patients. We sent 441 surveys to attending physicians and 353 surveys to PCPs and received 275 and 152 responses from 83 different attending physicians and 112 different PCPs, respectively (attending physician survey response rate of 63%). Intervention attending physicians and PCPs were significantly more aware of TPAD results (76% vs 38%, adjusted/clustered OR 6.30 (95% CI 3.02 to 13.16), p<0 .001="" 1.43="" 27.85="" 29="" 3.08="" 33="" 4.25="" 43="" 57="" 6.66="" actionable="" adjusted="" and="" attending="" aware="" be="" ci="" clustered="" eighteen="" hundred="" intervention.="" intervention="" more="" of="" one="" or="" p="" pcp="" physician="" physicians="" respectively="" respondents="" results="" satisfied="" survey="" tended="" this="" to="" tpad="" vs="" were="" with="">
Automated email notification represents a promising strategy for managing TPAD results, potentially mitigating an unresolved patient safety concern.
CLINICAL TRIAL REGISTRATION::
Tests pending at discharge, automated email notification, care transitions
- [PubMed - as supplied by publisher]
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