Journal:Advancing laboratory medicine in hospitals through health information exchange: A survey of specialist physicians in Canada
| 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]
References
- ↑ 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.
- ↑ American Clinical Laboratory Association. "Value of Lab Testing". https://www.acla.com/value-of-lab-testing/. Retrieved 16 May 2019.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Laposata, M. (2019). Laboratory medicine: The diagnosis of disease in the clinical laboratory (3rd ed.). McGraw-Hill Medical. ISBN 9781260116793.
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.
