Primary care practitioners' views on test result management in EHR-enabled health systems: a national survey
Open accessAbstract
CONTEXT: Failure to notify patients of test results is common even when electronic health records (EHRs) are used to report results to practitioners. We sought to understand the broad range of social and technical factors that affect test result management in an integrated EHR-based health system. METHODS: Between June and November 2010, we conducted a cross-sectional, web-based survey of all primary care practitioners (PCPs) within the Department of Veterans Affairs nationwide. Survey development was guided by a socio-technical model describing multiple inter-related dimensions of EHR use. FINDINGS: Of 5001 PCPs invited, 2590 (51.8%) responded. 55.5% believed that the EHRs did not have convenient features for notifying patients of test results. Over a third (37.9%) reported having staff support needed for notifying patients of test results. Many relied on the patient's next visit to notify them for normal (46.1%) and abnormal results (20.1%). Only 45.7% reported receiving adequate training on using the EHR notification system and 35.1% reported having an assigned contact for technical assistance with the EHR; most received help from colleagues (60.4%). A majority (85.6%) stayed after hours or came in on weekends to address notifications; less than a third reported receiving protected time (30.1%). PCPs strongly endorsed several new features to improve test result management, including better tracking and visualization of result notifications. CONCLUSIONS: Despite an advanced EHR, both social and technical challenges exist in ensuring notification of test results to practitioners and patients. Current EHR technology requires significant improvement in order to avoid similar challenges elsewhere.
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In previous work, the sociotechnical model was applicable in specific clinical contexts such as test results and referral communication.
“For instance, in our previous work, we found this sociotechnical model applicable in specific clinical contexts (eg, test results and referral communication), 43 -48”
From Exploring the sociotechnical intersection of patient safety and electronic health record implementation (2014) · cites this paper as [44]
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Medical Care Safety - Problems and Perspectives
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- Authors
- Singh, H., Spitzmueller, C., Petersen, N. J., Sawhney, M. K., Smith, M. W., Murphy, D. R., Espadas, D., Laxmisan, A., & Sittig, D. F.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- University of Houston (US)
- Memorial Hermann (US)
- Corresponding author
- Singh, Hardeep
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-07
- Volume
- 20
- Issue
- 4
- Pages
- 727-735
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC3721157
- OpenAlex
- W125667916
- Cited by
- 92
- References
- 59
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 7 · 2020: 5 · 2019: 10 · 2018: 8 · 2017: 8 · 2016: 7 · 2015: 11 · 2014: 8 · 2013: 7
- FWCI
- 13.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Medical Informatics Association (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Office of the National Coordinator for Health Information Technology (10510592)
- VA National Center for Patient Safety
- U.S. National Library of Medicine (R01LM006942)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- test result management, electronic health records, primary care physicians, socio-technical model, EHR usability, veterans' health care
- MeSH terms
- Cross-Sectional Studies, Diagnostic Tests, Routine, Humans, Primary Health Care, United States, Medical Records Systems, Computerized, Electronic Health Records, Physicians, Primary Care
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