Provider management strategies of abnormal test result alerts: a cognitive task analysis.
Objective: Electronic medical records (EMRs) facilitate abnormal test result communication through "alert" notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies...
| Publicado en: | Journal of the American Medical Informatics Association Vol. 17; no. 1; pp. 71 - 78 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Oxford University Press / USA
Jan2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105285979&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105285979 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10675027 FZ9 jtl: Journal of the American Medical Informatics Association issn: 10675027 maglogo: N pubinfo: dt: Jan2010 vid: 17 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 105285979 NLM20064805 2010528587 10.1197/jamia.M3200 NLM20064805 PMC2995633 105285979 ppf: 71 ppct: 7 formats: tig: atl: Provider management strategies of abnormal test result alerts: a cognitive task analysis. aug: au: Hysong SJ Sawhney MK Wilson L Sittig DF Espadas D Davis T Singh H Hysong, Sylvia J Sawhney, Mona K Wilson, Lindsay Sittig, Dean F Espadas, Donna Davis, Traber Singh, Hardeep affil: Houston VA HSR&D Center of Excellence, Michael E DeBakey Veterans Affairs Medical Center and the Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA sug: subj: Continuity of Patient Care Diagnostic Imaging Electronic Health Records Practice Patterns Reminder Systems Task Performance and Analysis Computer User Training Female Human Male Primary Health Care Texas Veterans Female Male ab: Objective: Electronic medical records (EMRs) facilitate abnormal test result communication through "alert" notifications. The aim was to evaluate how primary care providers (PCPs) manage alerts related to critical diagnostic test results on their EMR screens, and compare alert-management strategies of providers with high versus low rates of timely follow-up of results.Design: 28 PCPs from a large, tertiary care Veterans Affairs Medical Center (VAMC) were purposively sampled according to their rates of timely follow-up of alerts, determined in a previous study. Using techniques from cognitive task analysis, participants were interviewed about how and when they manage alerts, focusing on four alert-management features to filter, sort and reduce unnecessary alerts on their EMR screens.Results: Provider knowledge of alert-management features ranged between 4% and 75%. Almost half (46%) of providers did not use any of these features, and none used more than two. Providers with higher versus lower rates of timely follow-up used the four features similarly, except one (customizing alert notifications). Providers with low rates of timely follow-up tended to manually scan the alert list and process alerts heuristically using their clinical judgment. Additionally, 46% of providers used at least one workaround strategy to manage alerts.Conclusion: Considerable heterogeneity exists in provider use of alert-management strategies; specific strategies may be associated with lower rates of timely follow-up. Standardization of alert-management strategies including improving provider knowledge of appropriate tools in the EMR to manage alerts could reduce the lack of timely follow-up of abnormal diagnostic test results. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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