期刊
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
卷 17, 期 1, 页码 71-77出版社
HANLEY & BELFUS-ELSEVIER INC
DOI: 10.1197/jamia.M3200
关键词
-
类别
资金
- VA Career Development Award [CD2-07-0818]
- VA National Center of Patient Safety
- Houston VA HSR&D Center of Excellence [HFP90-020]
- VA Career Development Award
- NATIONAL CANCER INSTITUTE [K23CA125585] Funding Source: NIH RePORTER
Objective Electronic medical records (EMRs) facilitate abnormal test result communication through alert notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results. Design 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMIR screens. Results Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts. Conclusion Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据