Enhanced Lab Test Reports Useful for Primary Care Doctors

According to a recent study in the Journal of the American Medical Informatics (News - Alert) Association, primary care physicians respond positively to receiving additional from a patient’s electronic health record along with lab test results for that patient. Studies show that follow up of abnormal diagnostic test results without complete patient data is one of the major safety issues in outpatient practice. Putting the lab test results into the context of prior patient treatment, medications that they are taking and other information available on the electronic medical record could help primary care doctors and other care providers in providing the most appropriate follow up advice and treatment.

The researchers conducting this study used the information stored in a regional Health Information Exchange, the Indiana Network for Patient Care (INPC), to provide the additional data elements. The preliminary study was based on a list of 10 common laboratory tests to enhance, which were chosen because they typically require historical data for medical decision making. For each test result and lab report selected for enhancement, the researchers created a set of relevant lab test and medication associations. A third component of the enhanced report was a history of visits to providers within the INPC. Finally, a set of clinical reminders was created to help guide clinicians as they interpreted the ELRs and made medical decisions.

The ELR processor created a new message that appended the additional information to the original lab result, and delivered the ELR to the identified primary care physician. The researchers plan future studies of ELRs that will include a larger panel of evaluating physicians, increased number and complexity of rules that generate reminders, and the impact of ELRs on quality of care. The study was funded in part by the Agency for Healthcare Research and Quality (Contract No. 290-04-0015).

More details are in "Enhancing laboratory report contents to improve outpatient management of test results," by Kevin C. Chang, M.D., Dr. Overhage, Siu L. Hui, Ph.D, and others in the January/February 2010, Journal of the American Medical Informatics Association 17(1), pp. 99-103.