+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

Does integrating nonurgent, clinically significant radiology alerts within the electronic health record impact closed-loop communication and follow-up?

Journal of the American Medical Informatics Association 23(2): 333-338

To assess whether integrating critical result management software--Alert Notification of Critical Results (ANCR)--with an electronic health record (EHR)-based results management application impacts closed-loop communication and follow-up of nonurgent, clinically significant radiology results by primary care providers (PCPs). This institutional review board-approved study was conducted at a large academic medical center. Postintervention, PCPs could acknowledge nonurgent, clinically significant ANCR-generated alerts ("alerts") within ANCR or the EHR. Primary outcome was the proportion of alerts acknowledged via EHR over a 24-month postintervention. Chart abstractions for a random sample of alerts 12 months preintervention and 24 months postintervention were reviewed, and the follow-up rate of actionable alerts (eg, performing follow-up imaging, administering antibiotics) was estimated. Pre- and postintervention rates were compared using the Fisher exact test. Postintervention follow-up rate was compared for EHR-acknowledged alerts vs ANCR. Five thousand nine hundred and thirty-one alerts were acknowledged by 171 PCPs, with 100% acknowledgement (consistent with expected ANCR functionality). PCPs acknowledged 16% (688 of 4428) of postintervention alerts in the EHR, with the remaining in ANCR. Follow-up was documented for 85 of 90 (94%; 95% CI, 88%-98%) preintervention and 79 of 84 (94%; 95% CI, 87%-97%) postintervention alerts (P > .99). Postintervention, 11 of 14 (79%; 95% CI, 52%-92%) alerts were acknowledged via EHR and 68 of 70 (97%; 95% CI, 90%-99%) in ANCR had follow-up (P = .03). Integrating ANCR and EHR provides an additional workflow for acknowledging nonurgent, clinically significant results without significant change in rates of closed-loop communication or follow-up of alerts.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 057652732

Download citation: RISBibTeXText

PMID: 26335982

DOI: 10.1093/jamia/ocv105

Related references

Linking acknowledgement to action: closing the loop on non-urgent, clinically significant test results in the electronic health record. Journal of the American Medical Informatics Association 22(4): 905-908, 2015

Impact of integrating public health clinical decision support alerts into electronic health records on testing for gastrointestinal illness. Journal of Public Health Management and Practice 18(3): 224-227, 2012

Effect of modifying dose alerts in an electronic health record on frequency of alerts. American Journal of Health-System Pharmacy 76(Suppl._1): S1-S8, 2019

Impact of electronic health record-based alerts on influenza vaccination for children with asthma. Pediatrics 124(1): 159-169, 2009

Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population. Pediatrics 120(4): 707-714, 2007

744b Impact of Clinical Alerts Within Electronic Health Record on Infant Immunization Born to Chb Pregnant Mothers. Gastroenterology 150(4): S152-S153, 2016

How is your EMR communicating with radiology? Integrating radiology data into the electronic medical record. Healthcare Informatics 27(11): 20, 22, 2011

Development and validation of a dynamic inpatient risk prediction model for clinically significant hypokalemia using electronic health record data. American Journal of Health-System Pharmacy 2019, 2019

Impact of an electronic alert notification system embedded in radiologists' workflow on closed-loop communication of critical results: a time series analysis. BMJ Quality and Safety 25(7): 518-524, 2017

Using the electronic health record to connect primary care patients to evidence-based telephonic tobacco quitline services: a closed-loop demonstration project. Translational Behavioral Medicine 4(3): 324-332, 2014

Integrating Patient-Centered Electronic Health Record Communication Training into Resident Onboarding: Curriculum Development and Post-Implementation Survey Among Housestaff. Jmir Medical Education 4(1): E1, 2018

A systematic approach to optimize electronic health record medication alerts in a health system. American Journal of Health-System Pharmacy 76(8): 530-536, 2019

Using electronic health record alerts to provide public health situational awareness to clinicians. Journal of the American Medical Informatics Association 17(2): 217-219, 2010

Characterization of public health alerts and their suitability for alerting in electronic health record systems. Journal of Public Health Management and Practice 17(1): 77-83, 2013

Radiology reporting: a closed-loop cycle from order entry to results communication. Journal of the American College of Radiology 11(12 Pt B): 1226-1237, 2015