scholarly journals The impact of health information technology on the management and follow-up of test results – a systematic review

2019 ◽  
Vol 26 (7) ◽  
pp. 678-688 ◽  
Author(s):  
Andrew Georgiou ◽  
Julie Li ◽  
Judith Thomas ◽  
Maria R Dahm ◽  
Johanna I Westbrook
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Test Results ◽  
Health It ◽  
Point Change ◽  
It Systems ◽  
Results Management ◽  
The Impact

Abstract Objective To investigate the impact of health information technology (IT) systems on clinicians’ work practices and patient engagement in the management and follow-up of test results. Materials and Methods A search for studies reporting health IT systems and clinician test results management was conducted in the following databases: MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect, ProQuest, and Scopus from January 1999 to June 2018. Test results follow-up was defined as provider follow-up of results for tests that were sent to the laboratory and radiology services for processing or analysis. Results There are some findings from controlled studies showing that health IT can improve the proportion of tests followed-up (15 percentage point change) and increase physician awareness of test results that require action (24–28 percentage point change). Taken as whole, however, the evidence of the impact of health IT on test result management and follow-up is not strong. Discussion The development of safe and effective test results management IT systems should pivot on several axes. These axes include 1) patient-centerd engagement (involving shared, timely, and meaningful information); 2) diagnostic processes (that involve the integration of multiple people and different clinical settings across the health care spectrum); and 3) organizational communications (the myriad of multi- transactional processes requiring feedback, iteration, and confirmation) that contribute to the patient care process. Conclusion Existing evidence indicates that health IT in and of itself does not (and most likely cannot) provide a complete solution to issues related to test results management and follow-up.

scholarly journals Variation in electronic test results management and its implications for patient safety: A multisite investigation

2020 ◽  
Vol 27 (8) ◽  
pp. 1214-1224
Author(s):  
Judith Thomas ◽  
Maria R Dahm ◽  
Julie Li ◽  
Peter Smith ◽  
Jacqui Irvine ◽  
...  
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Health Information Technology ◽  
Health Information ◽  
Diagnostic Test ◽  
Test Results ◽  
Results Management ◽  
Result Management ◽  
Test Result

Abstract Objective The management and follow-up of diagnostic test results is a major patient safety concern. The aim of this qualitative study was to explore how clinicians manage test results on an everyday basis (work-as-done) in a health information technology–enabled emergency department setting. The objectives were to identify (1) variations in work-as-done in test results management and (2) the strategies clinicians use to ensure optimal management of diagnostic test results. Materials and Methods Qualitative interviews (n = 26) and field observations were conducted across 3 Australian emergency departments. Interview data coded for results management (ie, tracking, acknowledgment, and follow-up), and artifacts, were reviewed to identify variations in descriptions of work-as-done. Thematic analysis was performed to identify common themes. Results Despite using the same test result management application, there were variations in how the system was used. We identified 5 themes relating to electronic test results management: (1) tracking test results, (2) use and understanding of system functionality, (3) visibility of result actions and acknowledgment, (4) results inbox use, and (5) challenges associated with the absence of an inbox for results notifications for advanced practice nurses. Discussion Our findings highlight that variations in work-as-done can function to overcome perceived impediments to managing test results in a HIT-enabled environment and thus identify potential risks in the process. By illuminating work-as-done, we identified strategies clinicians use to enhance test result management including paper-based manual processes, cognitive reminders, and adaptive use of electronic medical record functionality. Conclusions Test results tracking and follow-up is a priority area in need of health information technology development and training to improve team-based collaboration/communication of results follow-up and diagnostic safety.

scholarly journals A Survey of the Literature on Unintended Consequences Associated with Health Information Technology: 2014–2015

2016 ◽  
Vol 25 (01) ◽  
pp. 13-29 ◽  
Author(s):  
J. Abraham ◽  
L. L. Novak ◽  
T. L. Reynolds ◽  
A. Gettinger ◽  
K. Zheng
Keyword(s):  
Information Technology ◽  
Time Series ◽  
Health Information Technology ◽  
Health Information ◽  
Unintended Consequences ◽  
Adverse Outcomes ◽  
Future Research ◽  
Health It ◽  
Recorded Data ◽  
The Impact

SummaryObjective: To summarize recent research on unintended consequences associated with implementation and use of health information technology (health IT). Included in the review are original empirical investigations published in English between 2014 and 2015 that reported unintended effects introduced by adoption of digital interventions. Our analysis focuses on the trends of this steam of research, areas in which unintended consequences have continued to be reported, and common themes that emerge from the findings of these studies.Method: Most of the papers reviewed were retrieved by searching three literature databases: MEDLINE, Embase, and CINAHL. Two rounds of searches were performed: the first round used more restrictive search terms specific to unintended consequences; the second round lifted the restrictions to include more generic health IT evaluation studies. Each paper was independently screened by at least two authors; differences were resolved through consensus development.Results: The literature search identified 1,538 papers that were potentially relevant; 34 were deemed meeting our inclusion criteria after screening. Studies described in these 34 papers took place in a wide variety of care areas from emergency departments to ophthalmology clinics. Some papers reflected several previously unreported unintended consequences, such as staff attrition and patients’ withholding of information due to privacy and security concerns. A majority of these studies (71%) were quantitative investigations based on analysis of objectively recorded data. Several of them employed longitudinal or time series designs to distinguish between unintended consequences that had only transient impact, versus those that had persisting impact. Most of these unintended consequences resulted in adverse outcomes, even though instances of beneficial impact were also noted. While care areas covered were heterogeneous, over half of the studies were conducted at academic medical centers or teaching hospitals. Conclusion: Recent studies published in the past two years represent significant advancement of unintended consequences research by seeking to include more types of health IT applications and to quantify the impact using objectively recorded data and longitudinal or time series designs. However, more mixed-methods studies are needed to develop deeper insights into the observed unintended adverse outcomes, including their root causes and remedies. We also encourage future research to go beyond the paradigm of simply describing unintended consequences, and to develop and test solutions that can prevent or minimize their impact.

scholarly journals Test results management and distributed cognition in electronic health record–enabled primary care

2018 ◽  
Vol 25 (4) ◽  
pp. 1549-1562 ◽  
Author(s):  
Michael W Smith ◽  
Ashley M Hughes ◽  
Charnetta Brown ◽  
Elise Russo ◽  
Traber D Giardina ◽  
...  
Keyword(s):  
Primary Care ◽  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Distributed Cognition ◽  
Primary Care Providers ◽  
Test Results ◽  
Team Members ◽  
Electronic Health ◽  
Results Management

Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses. We performed content analysis using a distributed cognition approach, identifying patterns of information transmission across people and artifacts (e.g. electronic health records). Results illustrate challenges (e.g. information overload) as well as strategies used to overcome challenges. Various communication paths were used. Some team members served as intermediaries, processing information before relaying it. Artifacts were used as memory aids. Health information technology should address the risks of distributed work by supporting awareness of team and task status for reliable management of results.

scholarly journals Human Factors for More Usable and Safer Health Information Technology: Where Are We Now and Where do We Go from Here?

2016 ◽  
Vol 25 (01) ◽  
pp. 120-125 ◽  
Author(s):  
C. Nohr ◽  
E. Borycki ◽  
A. Kushniruk
Keyword(s):  
Information Technology ◽  
Human Factors ◽  
Health Information Technology ◽  
Health Information ◽  
System Development ◽  
Unintended Consequences ◽  
Health It ◽  
Healthcare Settings ◽  
It Systems ◽  
Wide Range

SummaryA wide range of human factors approaches have been developed and adapted to healthcare for detecting and mitigating negative unexpected consequences associated with technology in healthcare (i.e. technology-induced errors). However, greater knowledge and wider dissemination of human factors methods is needed to ensure more usable and safer health information technology (IT) systems. Objective: This paper reports on work done by the IMIA Human Factors Working Group and discusses some successful approaches that have been applied in using human factors to mitigate negative unintended consequences of health IT. The paper addresses challenges in bringing human factors approaches into mainstream health IT development. Results: A framework for bringing human factors into the improvement of health IT is described that involves a multi-layered systematic approach to detecting technology-induced errors at all stages of a IT system development life cycle (SDLC). Such an approach has been shown to be needed and can lead to reduced risks associated with the release of health IT systems into live use with mitigation of risks of negative unintended consequences. Conclusion: Negative unintended consequences of the introduction of IT into healthcare (i.e. potential for technology-induced errors) continue to be reported. It is concluded that methods and approaches from the human factors and usability engineering literatures need to be more widely applied, both in the vendor community and in local and regional hospital and healthcare settings. This will require greater efforts at dissemination and knowledge translation, as well as greater interaction between the academic and vendor communities.

Analyzing the Role of Health Information Technology in Global Health Care

2017 ◽  
pp. 694-714
Author(s):  
Kijpokin Kasemsap
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Global Health ◽  
Patient Care ◽  
Health Information Technology ◽  
Health Information ◽  
Health Care Providers ◽  
Health It ◽  
Design Development ◽  
Global Health Care

This chapter explains the perspectives on global health, the overview of health information technology (health IT), the applications of electronic health record (EHR), and the importance of health IT in global health care. Health IT is the area of IT involving the design, development, creation, utilization, and maintenance of information systems for the health care industry. Health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. Effective health IT can lower costs, improve efficiency, and reduce medical error, while providing better patient care and service. The chapter argues that utilizing health IT has the potential to enhance health care performance and reach strategic goals in global health care.

Analyzing the Role of Health Information Technology in Global Health Care

2017 ◽  
pp. 287-307 ◽  
Author(s):  
Kijpokin Kasemsap
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Global Health ◽  
Patient Care ◽  
Health Information Technology ◽  
Health Information ◽  
Health Care Providers ◽  
Health It ◽  
Design Development ◽  
Global Health Care

This chapter explains the perspectives on global health, the overview of health information technology (health IT), the applications of electronic health record (EHR), and the importance of health IT in global health care. Health IT is the area of IT involving the design, development, creation, utilization, and maintenance of information systems for the health care industry. Health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. Effective health IT can lower costs, improve efficiency, and reduce medical error, while providing better patient care and service. The chapter argues that utilizing health IT has the potential to enhance health care performance and reach strategic goals in global health care.

Two Important Topics for 2012: Electronic Health Records and mHealth

2012 ◽  
Vol 47 (1) ◽  
pp. 62-63 ◽  
Author(s):  
I. Fox Brent ◽  
G. Felkey Bill
Keyword(s):  
Information Technology ◽  
Electronic Health Records ◽  
Health Information Technology ◽  
Health Information ◽  
Health It ◽  
Time And Space ◽  
Health Records ◽  
Electronic Health

As the new year begins, we like to reflect on where health information technology (IT) has been and where it is going. We are not fond of rehashing the minutia regarding every event that occurred in the health IT domain, so we will not spend our time and space presenting an exhaustive review. We will, however, touch on the continuing efforts surrounding electronic health records (EHRs). We will also focus forward in discussing an emerging area that we are closely following.

scholarly journals Managing the patient safety risks of bottom-up health information technology innovations: Recommendations for healthcare providers

2018 ◽  
Vol 25 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Mark A. Sujan
Keyword(s):  
Information Technology ◽  
Risk Management ◽  
Health Information Technology ◽  
Health Information ◽  
Management Strategies ◽  
Healthcare Providers ◽  
Local Health ◽  
Health It ◽  
Bottom Up ◽  
Patients At Risk

Health information technology (IT) offers exciting opportunities for providing novel services to patients, and for improving the quality and safety of care. Many healthcare professionals are already improving services through the development of numerous bottom-up local health IT innovations. Such innovations from the ground up are to be welcomed, but healthcare providers are struggling to develop processes for managing the risks that come with the introduction of health IT into clinical processes. I argue that too often the main strategy appears to be one of organisational ignorance. This puts patients at risk, and it threatens the successful adoption of health IT. I recommend that healthcare providers focus on strengthening their processes for organisational learning, promoting proactive risk management strategies, and making risk management decisions transparent and explicit.

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