Electronic Health Record Transition and Impact on Screening Test Follow-Up.
Jt Comm J Qual Patient Saf
; 47(7): 422-430, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33958289
ABSTRACT
INTRODUCTION:
Nonurgent clinically significant test results (CSTRs) are a common cause of missed and delayed diagnoses. However, little is known about the impact of electronic health record (EHR) transitions on CSTR follow-up. This study examines follow-up rates for three CSTRs (incidental pulmonary nodules [IPNs]), prostate-specific antigen [PSA], and Pap smears) before and after EHR transition.METHODS:
This is a retrospective cohort study at an urban tertiary medical center using an interrupted time series (ITS) design to assess monthly changes in CSTR follow-up-defined as completion of computed tomography chest imaging 5 to 13 months after first mention of an IPN in a radiology report; completion of a follow-up PSA test, urology visit, or prostate biopsy within 6 months of the first reported PSA > 4; or completion of a colposcopy or gynecology visit within 6 months of a first reported abnormal Pap smear. Patients were included with first-onset abnormal CSTRs for IPN, PSAs > 4, or abnormal Pap smears occurring in the 24 months before and after the EHR transition.RESULTS:
There were no significant differences in follow-up in the IPN or the Pap smear ITS models. In the PSA ITS model, follow-up was significantly decreasing (pâ¯=â¯0.0133) in the preintervention period, and there was a significant change in trend from intervention to postintervention (pâ¯=â¯0.0279).CONCLUSION:
EHR transition reversed a decreasing trend over time for PSA test follow-up, while IPN and Pap smear follow-up trends did not change significantly. Effects of EHR transition may differ by test studied.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Registros Eletrônicos de Saúde
/
Teste de Papanicolaou
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Limite:
Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article