Physicians fail to share abnormal test results with patients in one out of every 14 medical tests, undermining the claimed efficacy of electronic medical records, according to a recent study.
“The electronic medical record doesn’t magically fix the problem,” said Lawrence Casalino, MD, of Weill Cornell Medical College in New York, who led the study, published in the Archives of Internal Medicine.
The report’s authors said the new wave of electronic medical record keeping hasn’t reduced the number of mistakes, despite the fact that advocates for the digitization of medical records had more or less guaranteed that it would eliminate those errors.
Not keeping patients up-to-date on their own medical conditions is more than just a breach of trust, they noted; it can also be extremely dangerous
“There are many steps in the testing process, which extends from ordering a test to providing appropriate follow-up,” said Casalino, “An error in any one of these steps can have lethal consequences.”
The failure to diagnose is one of the most common causes of malpractice suits, he added.
Patients who are not kept up-to-date on their condition frequently delay seeking crucial treatments – delays that can significantly affect a patient’s chances of survival, he said.
Casalino’s team examined more than 5,000 medical records from 23 doctors’ offices and hospitals across the country. The team looked at abnormal test results for high cholesterol, diabetes and various forms of cancer, then cross-referenced them to determine which patients had not been notified of their conditions.
On average, they found that in 7.1 percent of the cases, doctors didn’t inform patients of their test results.
The results ranged from medical practices whose physicians contacted patients with abnormal test results every time to those whose physicians failed to let one of every four patients know about potentially dangerous conditions.
Perhaps most telling, the researchers observed that medical practices with the worst records used a so-called partial electronic medical records system – a mixture of electronic and old-school paper records. No statistically significant difference was observed between practices using only paper records and those using only electronic records.
“We found that very few physician practices had explicit rules for managing test results,” Casalino said. “In many practices, each physician devised his or her own method. And in many cases, physicians and their staff told patients that ‘no news is good news’ – meaning they should assume that their test results were normal unless they are told otherwise. This is a dangerous assumption.”
“This study concerns the effectiveness of a practice to communicate abnormal lab results. Its concern is the communication pattern with patients,” said Peter Waegemann, CEO of the mHealth Initiative, Inc., a Boston-based, not-for-profit organization advocating the development of healthcare applications for mobile devices. “It doesn’t matter whether a physician has a partial EMR or not, (he or she) still has to find time to contact the patient and communicate the message.”
