Physicians failed to tell patients that they had an abnormal test result in one out of 14 cases, and electronic health records (referred to as electronic medical records in this study) can make the failure rate worse, according to a study published in the Archives of Internal Medicine.
A review of more than 5,400 patient records from 23 physician groups in Midwest and Western states indicated that practices with simple processes to manage test results were better at informing patients about their abnormal test results.
In some medical groups, the failure-to-inform rate was close to zero, while in others it was as high as one in four abnormal results, according to the study, led by Lawrence Casalino, chief of the Outcomes and Effectiveness Research Division at the Weill Cornell Medical College in New York. The study looked at 11 blood tests and three screenings, including mammography, given to patients ages 50 to 69 years old.
Having an EMR did not necessarily improve communication with patients about test results. In fact, practices that had a combination of paper and electronic records, called a partial EMR, had the worst track record for informing patients of an abnormal result, according to the study, which was funded by the California HealthCare Foundation.
We observed practices that use EMRs in which the only way to see a test result is by searching on the record of each patient for whom a physician ordered a test, Casalino wrote in the paper. In these practices, we found individual physicians devising their own methods, such as Excel spreadsheets, to help them remember to check for results.