In response to reader commentary on Rebecca Vesely's “EHRs hinder abnormal test result disclosure: study":
Fragmented data disrupt docs' careflow
Although it is not yet widely acknowledged, caregiver workflow is being disrupted by both paper and electronic health-record-based test results that are reported as fragmented and incomplete data in variable formats. Even with existing noninteroperable EHR systems, with large volumes of results, this flawed format design can actually hide key individual results from doctors, obscure important trends and contribute to errors and waste, including estimated duplicate testing rates of 15% to 20%.
In the emerging interoperable EHR, personal health record and health information exchange platform era, with its financial incentives and subsidies for meaningful use of physician office and hospital EHRs, providing the semantic and workflow “layers” of interoperability will be as important to efficient information exchange as establishing the technical interoperability standards—like the Health Level 7 clinical messaging standard for laboratory test results—on which these layers depend.
From the perspective of physicians and nurses, all types of EHRs should be specifically designed to enhance, not impede, all of their clinical and administrative workflow processes.
There is one new process available that can ensure that results get to physicians and patients and that they can view and share them efficiently for the first time. This requires a transformation to a standardized test results reporting format that allows EHR, PHR and HIE platforms to display complete, integrated information that is easy for primary-care physicians, specialists, nurses and patients to read, understand and share.
Bob Coli, M.D.Founder and CEODiagnostic Information System Co.Warwick, R.I.
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