7.1% of patients are not notified of abnormal outpatient test results (or the notification is not documented) affecting 1 in 14 patients, with failure rates ranging as high as 1 in 4 patients in some practices. The health implications of this finding are significant.
The study led by Dr. Lawrence Casalino of Weill Cornell Medical College found that "having an electronic medical record did not reduce failure-to-inform rates — and even increased them — if the practice did not have good processes in place for managing test results... The study suggests that five simple, common-sense processes are useful for dealing with test results: (1) all test results are routed to the responsible physician; (2) the physician signs off on all results; (3) the practice informs patients of all results, normal and abnormal, at least in general terms; (4) the practice documents that the patient has been informed; and (5) patients are told to call after a certain time interval if they have not been notified."
The full study - "Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results" - in the Archives of Internal Medicine reports that "use of a 'partial electronic medical record' (paper-based progress notes and electronic test results or vice versa) was associated with higher failure rates compared with not having an electronic medical record or with having an electronic medical record that included both progress notes and test results. "
The authors concluded that "they did not find a significant difference between practices that had a 'complete' EMR and those that used paper records; this may be because there is no difference or because the number of practices included was not large enough to detect a difference."