Impact of an automated test results management system on patients' satisfaction about test result communication

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Introduction: This paper is a report about a study that was conducted to understand the impact on how satisfied patients were with how their test results were communicated to them from physicians who use a test results management tool which is in an electronic health record system.

Background: Multiple studies in the past have shown that poor communication of test results to patients have been associated with treatment delays and missed opportunities for follow-ups. This study was conducted to address this issue and to determine if test result management tools can improve test result communication.

Methods: The study that was conducted was a prospective, randomized, clinic-clustered trial. It took place at Partners HealthCare System in Massachusetts and the automated system that was used was Results Manager. This system tracks all test results ordered by a physician and is continually updated. Out of 26 primary care adult clinics, half were randomly chosen as control clinics and the other half were chosen as intervention clinics. Then patients were randomly sampled from each of these groups of clinics. Baseline measurements were taken between Dec. 1, 2002 to June 30, 2003 and post intervention measurements were taken between Aug. 1, 2003 to April 31, 2005.

Results: In total, 1586 patients were sampled, but only 570 patients completed the surveys, which was a 74.2% successful survey completion. After adjusting for patient race, sex, insurance type, age and self-reported health status, it was shown that the use of the automated test results manager increased patient’s satisfaction of test result communication. It was also shown that there was an increase in patient’s satisfaction with the communication of their treatment and condition.

Discussion: The report described multiple factors that could have contributed to the results. These factors are a concise summary of test results, a template-based results letter generator in the system, and patient contact information attached to the results which all are potential workflow improvements from the system. The limitations of this study were the limit of generalizing by the tool’s development in the custom-built EHR, the potential bias from responders as opposed to non-responders of the survey and the potential bias from survey questions and how they were asked. All of these limitations were addressed by the researchers and the biases were determined to be equal across all control and intervention groups. The researchers also mentioned that an area of future research would be the impact of an automated test result tool on non-English speaking patients.