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Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain?
Singh H, Thomas EJ, Sittig DF, et al. Am J Med. 2010;123:238-244.
Unreliable
test result management systems
are a common problem in
ambulatory care
, and failure (or inability) to promptly follow up abnormal test results may lead to
diagnostic errors
and other safety problems. Automated alerts within electronic health records should minimize such problems. However, this study conducted in Veterans Affairs clinics found that 1 in 10 alerts for abnormal laboratory test results went unread by providers, and a large proportion of those patients did not receive timely clinical follow-up. The investigators found similar results when analyzing follow-up of alerts for
abnormal imaging results
. "
Alert fatigue
" is one possible explanation for these findings.
PubMed citation
Available at
Related Resources
COMMENTARY
Unintended errors with EHR-based result management: a case series.
Yackel TR, Embi PJ. J Am Med Inform Assoc. 2010;17:104-107.
STUDY
The management of test results in primary care: does an electronic medical record make a difference?
Elder NC, McEwen TR, Flach J, Gallimore J, Pallerla H. Fam Med. 2010;42:327-333.
STUDY
Electronic health record-based surveillance of diagnostic errors in primary care.
Singh H, Giardina TD, Forjuoh SN, et al. BMJ Qual Saf. 2012;22:93-100.
STUDY
Outpatient adverse drug events identified by screening electronic health records.
Gandhi TK, Seger AC, Overhage JM, et al. J Patient Saf. 2010;6;91-96.
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Resource Type
Study
Setting of Care
Ambulatory Clinic or Office
Target Audience
Health Care Providers
Facility and Group Administrators
Information Professionals
Clinical Area
Pathology & Laboratory Medicine
Safety Target
Diagnostic Errors
Missed or Critical Lab Results
Approach to Improving Safety
Laboratory Result Tracking Improvement
Computerized Adverse Event Detection
Electronic Health Records
Origin/Sponsor
Department of Veterans Affairs (VA)