Survey findings suggest that significant problems exist with test result management systems in primary care physicians’ offices

Delays in reviewing test results are common, and many physicians are not satisfied with how they are able to manage test results, according to an article in the November 8 issue of The Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, failure to follow up with patients about their test results is a patient safety and malpractice concern, and lack of timely follow-up can jeopardize patient safety and satisfaction.

Eric G. Poon, M.D., M.P.H., of Brigham and Women’s Hospital, Boston, and colleagues attempted to identify problems in current test result management systems and developed possible alternatives for improving these systems.

The researchers surveyed 262 physicians (64 percent response rate) working in 15 internal medicine practices affiliated with two large, urban teaching hospitals. Physicians were asked about specific systems they used to manage test results and how much time they spent managing test results.

Of the physicians who completed the surveys, 83 percent reported at least one delay in reviewing test results during the previous two months. “Despite reporting that they spent on average 74 minutes per clinical day managing test results, only 41 percent of physicians reported being satisfied with how they managed test results,” the article states. The features physicians most wanted to help with test result management were tools to help them generate result letters to patients, prioritize their workflow and track test orders through to completion.

“Our survey findings suggest that significant problems exist with test result management systems in primary care physicians’ offices,” the authors write. “The high frequency of reported delays is important since self-reporting typically significantly underestimates the true incidence of errors. The relationship between self-reported delays and dissatisfaction suggests that physicians also recognized delays in test result review as a significant problem affecting quality of care and patient safety. While our survey did not directly characterize the clinical importance of these delays, the fact that physicians ‘wished they had known about’ these results earlier strongly suggests that many of these results might have changed patient management.”