Difference between revisions of "Journal:Advancing laboratory medicine in hospitals through health information exchange: A survey of specialist physicians in Canada"

From LIMSWiki
Jump to navigationJump to search
(Saving and adding more.)
(Saving and adding more.)
Line 35: Line 35:


A recent study found that among seven countries, Canada ranked second in terms of physician self-reported errors in laboratory and diagnostic processes, as well as delays in reporting abnormal results.<ref name="O'HaganSelf09">{{cite journal |title=Self-reported medical errors in seven countries: Implications for Canada |journal=Healthcare Quarterly |author=O'Hagan, J.; MacKinnon, N.J.; Persaud, D. et al. |volume=12 |pages=55–61 |year=2009 |doi=10.12927/hcq.2009.20967 |pmid=19667778}}</ref> One way to improve the quality and safety of patient care is to emphasize prevention and error management using well-designed information technology (IT) systems.<ref name="FeldmanHealth18">{{cite journal |title=Health Information Technology in Healthcare Quality and Patient Safety: Literature Review |journal=JMIR Medical Informatics |author=Feldman, S.S.; Buchalter, S.; Hayes, L.W. et al. |volume=6 |issue=2 |at=e10264 |year=2018 |doi=10.2196/10264 |pmid=29866642 |pmc=PMC6006013}}</ref><ref name="LifshitzOptim17">{{cite book |chapter=Optimizing Laboratory Workflow and Performance |title=Henry's Clinical Diagnosis and Management by Laboratory Methods |author=Lifshitz, M.S. |editor=McPherson, R.A.; Pincus, M.R. |edition=23rd |publisher=Elsevier Health Sciences |year=2017 |pages=11–19 |isbn=9780323295680}}</ref> Indeed, the laboratory testing process involves the constant exchange of [[information]] among patients, physicians, nurses, and laboratory specialists which, nowadays, is supported by multiple IT systems and platforms.<ref name="CallenTheSafety11">{{cite journal |title=The safety implications of missed test results for hospitalised patients: A systematic review |journal=BMJ Quality and Safety |author=Callen, J.; Georgiou, A.; Li, J. et al. |volume=20 |issue=2 |pages=194–9 |year=2011 |doi=10.1136/bmjqs.2010.044339 |pmid=21300992 |pmc=PMC3038104}}</ref>
A recent study found that among seven countries, Canada ranked second in terms of physician self-reported errors in laboratory and diagnostic processes, as well as delays in reporting abnormal results.<ref name="O'HaganSelf09">{{cite journal |title=Self-reported medical errors in seven countries: Implications for Canada |journal=Healthcare Quarterly |author=O'Hagan, J.; MacKinnon, N.J.; Persaud, D. et al. |volume=12 |pages=55–61 |year=2009 |doi=10.12927/hcq.2009.20967 |pmid=19667778}}</ref> One way to improve the quality and safety of patient care is to emphasize prevention and error management using well-designed information technology (IT) systems.<ref name="FeldmanHealth18">{{cite journal |title=Health Information Technology in Healthcare Quality and Patient Safety: Literature Review |journal=JMIR Medical Informatics |author=Feldman, S.S.; Buchalter, S.; Hayes, L.W. et al. |volume=6 |issue=2 |at=e10264 |year=2018 |doi=10.2196/10264 |pmid=29866642 |pmc=PMC6006013}}</ref><ref name="LifshitzOptim17">{{cite book |chapter=Optimizing Laboratory Workflow and Performance |title=Henry's Clinical Diagnosis and Management by Laboratory Methods |author=Lifshitz, M.S. |editor=McPherson, R.A.; Pincus, M.R. |edition=23rd |publisher=Elsevier Health Sciences |year=2017 |pages=11–19 |isbn=9780323295680}}</ref> Indeed, the laboratory testing process involves the constant exchange of [[information]] among patients, physicians, nurses, and laboratory specialists which, nowadays, is supported by multiple IT systems and platforms.<ref name="CallenTheSafety11">{{cite journal |title=The safety implications of missed test results for hospitalised patients: A systematic review |journal=BMJ Quality and Safety |author=Callen, J.; Georgiou, A.; Li, J. et al. |volume=20 |issue=2 |pages=194–9 |year=2011 |doi=10.1136/bmjqs.2010.044339 |pmid=21300992 |pmc=PMC3038104}}</ref>
Missing laboratory results may have considerable consequences for patients and are due to several factors, including the way systems and practices are used to monitor test results, how critical results are managed, and how care is transitioned across settings.<ref name="CallenTheSafety11" /> To prevent medical errors<ref name="FeldmanHealth18" />, medical laboratories have deployed [[laboratory information system]]s (LIS) with user-friendly interfaces, tracking tools, and electronic alerts<ref name="WalzPatient13" /><ref name="EtchellsReal11">{{cite journal |title=Real-time automated paging and decision support for critical laboratory abnormalities |journal=BMJ Quality and Safety |author=Etchells, E.; Adkhikari, N.K.J.; Wu, R. et al. |volume=20 |issue=11 |pages=924–30 |year=2011 |doi=10.1136/bmjqs.2010.051110 |pmid=21725046}}</ref>; [[computerized physician order entry]] (CPOE) systems; and [[clinical decision support system]]s.<ref name="ProcopDuplicate14">{{cite journal |title=Duplicate laboratory test reduction using a clinical decision support tool |journal=American Journal of Clinical Pathology |author=Procop, G.W.; Yerian, L.M.; Wyllie, R. et al. |volume=141 |issue=5 |pages=718–23 |year=2014 |doi=10.1309/AJCPOWHOIZBZ3FRW |pmid=24713745}}</ref> These systems empower laboratory specialists to enhance the interpretation of test results in order to better support physicians in their quest for better and safer patient care.<ref name="WalzPatient13" /> Although physicians may have access to an LIS, these systems are primarily designed to meet the needs of laboratory personnel. Therefore, other laboratory information exchange (LIE) systems are required to improve the reliability of the laboratory testing process<ref name="MurphyBarriers19">{{cite journal |title=Barriers and facilitators impacting reliability of the electronic health record-facilitated total testing process |journal=International Journal of Medical Informatics |author=Murphy, D.R.; Satterly, T.; Rogith, D.. et al. |volume=127 |pages=102–08 |year=2019 |doi=10.1016/j.ijmedinf.2019.04.004 |pmid=31128821}}</ref> and, hence, need to be integrated with other clinical information systems physicians use in hospitals such as [[electronic health record]]s (EHRs).<ref name="KaelberHealth07">{{cite journal |title=Health information exchange and patient safety |journal=Journal of Biomedical Informatics |author=Kaelber, D.C.; Bates, D.W. |volume=40 |issue=6 Suppl. |pages=S40-5 |year=2007 |doi=10.1016/j.jbi.2007.08.011 |pmid=17950041}}</ref><ref name="WilkersonMan15">{{cite journal |title=Management of laboratory data and information exchange in the electronic health record |journal=Archives of Pathology and Laboratory Medicine |author=Wilkerson, M.L.; Henricks, W.H.; Casellani, W.J. et al. |volume=139 |issue=3 |pages=319–27 |year=2015 |doi=10.5858/arpa.2013-0712-SO |pmid=25724028}}</ref>




Revision as of 20:06, 3 August 2020

Full article title Advancing laboratory medicine in hospitals through health information exchange: A survey of specialist physicians in Canada
Journal BMC Medical Informatics and Decision Making
Author(s) Raymond, Louis; Maillet, Éric; Trudel, Marie-Claude; Marsan, Josianne; de Guniea, Ana Ortiz; Paré, Guy
Author affiliation(s) Université du Québec à Trois-Rivières, Université de Sherbrooke, HEC Montréal, Université Laval
Primary contact Online contact form
Year published 2020
Volume and issue 20
Article # 44
DOI 10.1186/s12911-020-1061-z
ISSN 1472-6947
Distribution license Creative Commons Attribution 4.0 International
Website https://link.springer.com/article/10.1186/s12911-020-1061-z
Download https://link.springer.com/content/pdf/10.1186/s12911-020-1061-z.pdf (PDF)

Abstract

Background: Laboratory testing occupies a prominent place in healthcare. Information technology systems have the potential to empower laboratory experts and to enhance the interpretation of test results in order to better support physicians in their quest for better and safer patient care. This study sought to develop a better understanding of which laboratory information exchange (LIE) systems and features specialist physicians are using in hospital settings to consult their patients’ laboratory test results, and what benefit they derive from such use.

Methods: As part of a broader research program on the use of health information exchange systems for laboratory medicine in Quebec, Canada, this study was designed as on online survey. Our sample is composed of 566 specialist physicians working in hospital settings, out of the 1,512 physicians who responded to the survey (response rate of 17%). Respondents are representative of the targeted population of specialist physicians in terms of gender, age, and hospital location.

Results: We first observed that 80% of the surveyed physicians used the province-wide interoperable electronic health records (iEHR) system, and 93% used a laboratory results viewer (LRV) to consult laboratory test results, while most (72%) use both systems to retrieve lab results. Next, our findings reveal important differences in the capabilities available in each type of system and in the use of these capabilities. Third, there are differences in the nature of the perceived benefits obtained from the use of each of these two systems. Last, the extent of use of an LRV is strongly influenced by the IT artefact itself (i.e., the hospital’s LRV available capabilities), while the use of the provincial iEHR system is influenced by its organizational context (i.e., the hospital’s size and location).

Conclusions: The main contribution of this study lies in its insights into the role played by context in shaping physicians’ choices about which LIE systems to adopt, which features to use, and the different perceptions they have about benefits arising from such use. One related implication for practice is that success of LIE initiatives should not be solely assessed with basic usage statistics.

Keywords: laboratory information exchange, information systems, laboratory medicine, specialist physician, hospital, perceived benefits, online survey research

Background

Laboratory testing occupies a prominent place in healthcare.[1] For instance, more than seven billion laboratory tests are performed each year in the United States.[2] It is also reported that about 70% of all medical decisions are based on laboratory test results.[3] In hospital settings, which are the focus of the present study, 98% of admitted patients have one or more laboratory tests prescribed.[4] To provide services across a broad continuum and to perform increasingly complex tests, laboratories require sophisticated medical technologies and highly qualified staff.[1] Faced with this growing complexity, treating physicians must be able to rely on consistent clinical support provided by laboratory medicine specialists such as radiologists and pathologists.[5][6]

A recent study found that among seven countries, Canada ranked second in terms of physician self-reported errors in laboratory and diagnostic processes, as well as delays in reporting abnormal results.[7] One way to improve the quality and safety of patient care is to emphasize prevention and error management using well-designed information technology (IT) systems.[8][9] Indeed, the laboratory testing process involves the constant exchange of information among patients, physicians, nurses, and laboratory specialists which, nowadays, is supported by multiple IT systems and platforms.[10]

Missing laboratory results may have considerable consequences for patients and are due to several factors, including the way systems and practices are used to monitor test results, how critical results are managed, and how care is transitioned across settings.[10] To prevent medical errors[8], medical laboratories have deployed laboratory information systems (LIS) with user-friendly interfaces, tracking tools, and electronic alerts[5][11]; computerized physician order entry (CPOE) systems; and clinical decision support systems.[12] These systems empower laboratory specialists to enhance the interpretation of test results in order to better support physicians in their quest for better and safer patient care.[5] Although physicians may have access to an LIS, these systems are primarily designed to meet the needs of laboratory personnel. Therefore, other laboratory information exchange (LIE) systems are required to improve the reliability of the laboratory testing process[13] and, hence, need to be integrated with other clinical information systems physicians use in hospitals such as electronic health records (EHRs).[14][15]


References

  1. ↑ 1.0 1.1 Hilbert, T.; Kurec, A.; Lifshitz, M.S. (2017). "General Concepts and Administrative Issues". In McPherson, R.A.; Pincus, M.R.. Henry's Clinical Diagnosis and Management by Laboratory Methods (23rd ed.). Elsevier Health Sciences. pp. 2–10. ISBN 9780323295680. 
  2. ↑ American Clinical Laboratory Association. "Value of Lab Testing". https://www.acla.com/value-of-lab-testing/. Retrieved 16 May 2019. 
  3. ↑ Silverstein, M.D. (8 April 2003). "An Approach to Medical Errors and Patient Safety in Laboratory Services" (PDF). http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.597.741&rep=rep1&type=pdf. 
  4. ↑ Ngo, A.; Gandhi, P.; Miller, W.G. (2017). "Frequency that Laboratory Tests Influence Medical Decisions". Journal of Applied Laboratory Medicine 1 (4): 410–14. doi:10.1373/jalm.2016.021634. 
  5. ↑ 5.0 5.1 5.2 Walz, S.E.; Darcy, T.P. (2013). "Patient safety & post-analytical error". Clinics in Laboratory Medicine 33 (1): 183–94. doi:10.1016/j.cll.2012.10.001. PMID 23331737. 
  6. ↑ Laposata, M. (2019). Laboratory medicine: The diagnosis of disease in the clinical laboratory (3rd ed.). McGraw-Hill Medical. ISBN 9781260116793. 
  7. ↑ O'Hagan, J.; MacKinnon, N.J.; Persaud, D. et al. (2009). "Self-reported medical errors in seven countries: Implications for Canada". Healthcare Quarterly 12: 55–61. doi:10.12927/hcq.2009.20967. PMID 19667778. 
  8. ↑ 8.0 8.1 Feldman, S.S.; Buchalter, S.; Hayes, L.W. et al. (2018). "Health Information Technology in Healthcare Quality and Patient Safety: Literature Review". JMIR Medical Informatics 6 (2): e10264. doi:10.2196/10264. PMC PMC6006013. PMID 29866642. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006013. 
  9. ↑ Lifshitz, M.S. (2017). "Optimizing Laboratory Workflow and Performance". In McPherson, R.A.; Pincus, M.R.. Henry's Clinical Diagnosis and Management by Laboratory Methods (23rd ed.). Elsevier Health Sciences. pp. 11–19. ISBN 9780323295680. 
  10. ↑ 10.0 10.1 Callen, J.; Georgiou, A.; Li, J. et al. (2011). "The safety implications of missed test results for hospitalised patients: A systematic review". BMJ Quality and Safety 20 (2): 194–9. doi:10.1136/bmjqs.2010.044339. PMC PMC3038104. PMID 21300992. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038104. 
  11. ↑ Etchells, E.; Adkhikari, N.K.J.; Wu, R. et al. (2011). "Real-time automated paging and decision support for critical laboratory abnormalities". BMJ Quality and Safety 20 (11): 924–30. doi:10.1136/bmjqs.2010.051110. PMID 21725046. 
  12. ↑ Procop, G.W.; Yerian, L.M.; Wyllie, R. et al. (2014). "Duplicate laboratory test reduction using a clinical decision support tool". American Journal of Clinical Pathology 141 (5): 718–23. doi:10.1309/AJCPOWHOIZBZ3FRW. PMID 24713745. 
  13. ↑ Murphy, D.R.; Satterly, T.; Rogith, D.. et al. (2019). "Barriers and facilitators impacting reliability of the electronic health record-facilitated total testing process". International Journal of Medical Informatics 127: 102–08. doi:10.1016/j.ijmedinf.2019.04.004. PMID 31128821. 
  14. ↑ Kaelber, D.C.; Bates, D.W. (2007). "Health information exchange and patient safety". Journal of Biomedical Informatics 40 (6 Suppl.): S40-5. doi:10.1016/j.jbi.2007.08.011. PMID 17950041. 
  15. ↑ Wilkerson, M.L.; Henricks, W.H.; Casellani, W.J. et al. (2015). "Management of laboratory data and information exchange in the electronic health record". Archives of Pathology and Laboratory Medicine 139 (3): 319–27. doi:10.5858/arpa.2013-0712-SO. PMID 25724028. 

Notes

This presentation is faithful to the original, with only a few minor changes to presentation, grammar, and punctuation. In some cases important information was missing from the references, and that information was added.

Retrieved from "https://www.limswiki.org/index.php?title=Journal:Advancing_laboratory_medicine_in_hospitals_through_health_information_exchange:_A_survey_of_specialist_physicians_in_Canada&oldid=39997"