Laboratory testing in primary care: A systematic review of health IT impacts

International Journal of Medical Informatics

Volumn 116, Issue , 2018, Pages 52-69

  Maillet, Éric ^a   Paré, Guy ^b   Currie, Leanne M ^c   Raymond, Louis ^d   Ortiz de Guinea, Ana ^b,e   Trudel, Marie Claude ^b   Marsan, Josianne ^f  

^a UNIVERSITÉ DE SHERBROOKE   (Canada)

^b HEC MONTRÉAL   (Canada)

^c UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^d UNIVERSITÉ DU QUÉBEC À TROIS RIVIÈRES   (Canada)

^e UNIVERSITY OF DEUSTO   (Spain)

^f UNIVERSITÉ LAVAL   (Canada)

Author keywords

Clinical decision making; Information technology; Laboratory; Medical errors; Primary care; Total testing process

Indexed keywords

COGNITIVE SYSTEMS; DECISION MAKING; ERRORS; HEALTH; INFORMATION TECHNOLOGY; KNOWLEDGE MANAGEMENT; LABORATORIES; TURNAROUND TIME;

BEST PRACTICE GUIDELINES; CLINICAL DECISION MAKING; HEALTH INFORMATION TECHNOLOGIES; MEDICAL ERRORS; ORGANIZATIONAL BARRIERS; PRIMARY CARE; PRIMARY-CARE CLINICIANS; TESTING PROCESS;

INFORMATION USE;

CLINICAL DECISION MAKING; FOLLOW UP; HUMAN; LABORATORY TEST; MEDICAL ERROR; MEDICAL INFORMATICS; MEDICAL RESEARCH; POST-ANALYTICAL PHASE; PRACTICE GUIDELINE; PRE-ANALYTICAL PHASE; PRIMARY MEDICAL CARE; PRIORITY JOURNAL; REVIEW; SYSTEMATIC REVIEW; TURNAROUND TIME; FACTUAL DATABASE; HEALTH CARE PERSONNEL; LABORATORY TECHNIQUE; ORGANIZATION AND MANAGEMENT; PRIMARY HEALTH CARE; PROCEDURES;

CLINICAL LABORATORY TECHNIQUES; DATABASES, FACTUAL; HEALTH PERSONNEL; HUMANS; PRIMARY HEALTH CARE;

EID: 85048203748     PISSN: 13865056     EISSN: 18728243     Source Type: Journal    
DOI: 10.1016/j.ijmedinf.2018.05.009     Document Type: Review

References (77)

1. Callen, J., Georgiou, A., Li, J., Westbrook, J.I., The safety implications of missed test results for hospitalised patients: a systematic review. BMJ Qual. Saf. 20:2 (2011), 194–199, 10.1136/bmjqs.2010.044339.
2. National Academy of Medicine, Improving Diagnosis in Health Care. 2015, National Academies Press, Washington, DC 978-0-309-37769-0.
3. Litchfield, I.J., Bentham, L.M., Lilford, R.J., Greenfield, S.M., Test result communication in primary care: clinical and office staff perspectives. Fam. Pract. 31:5 (2014), 592–597, 10.1093/fampra/cmu041.
4. Wallin, O., Söderberg, J., Van Guelpen, B., Brulin, C., Grankvist, K., Patient-centred care–preanalytical factors demand attention: a questionnaire study of venous blood sampling and specimen handling. Scand. J. Clin. Lab. Invest. 67:8 (2007), 836–847 PubMed PMID: 17852838.
5. White, B., Four principles for better test-result tracking. Fam. Pract. Manag. 9:7 (2001), 41–44.
6. Stroobants, A.K., Goldschmidt, H.M.J., Plebani, M., Error budget calculations in laboratory medicine: linking the concepts of biological variation and allowable medical errors. Clin. Chim. Acta 333:2 (2003), 169–176, 10.1016/S0009-8981(03)00181-5.
7. Plebani, M., Exploring the iceberg of errors in laboratory medicine. Clin. Chim. Acta 404:1 (2009), 16–23, 10.1016/j.cca.2009.03.022.
8. Plebani, M., Laposata, M., Lundberg, G.D., The brain-to-brain loop concept for laboratory testing 40 years after its introduction. Am. J. Clin. Pathol. 136:6 (2011), 829–833, 10.1309/ajcpr28hwhssdnon.
9. Norman, G.R., Eva, K.W., Diagnostic error and clinical reasoning. Med. Educ. 44:1 (2010), 94–100, 10.1111/j.1365-2923.2009.03507.x.
10. Elder, N., Hickner, J., Graham, D., Quality and safety in outpatient laboratory testing. Clin. Lab. Med. 28:2 (2008), 295–303.
11. American College of Physicians, Reform of the Dysfunctional Healthcare Payment and Delivery System. 2006 (accessed May 31, 2016) https://www.acponline.org/system/files/documents/advocacy/current_policy_papers/assets/dysfunctional_payment.pdf.
12. Elder, N.C., McEwen, T.R., Flach, J.M., Gallimore, J.J., Management of test results in family medicine offices. Ann. Fam. Med. 7:4 (2009), 343–351.
13. Beasley, J.W., Wetterneck, T.B., Temte, J., Lapin, J.A., Smith, P., Rivera-Rodriguez, A.J., et al. Information chaos in primary care: implications for physician performance and patient safety. J. Am. Board Fam. Med. 24:6 (2011), 745–751, 10.3122/jabfm.2011.06.100255.
14. Hickner, J., Thompson, P.J., Wilkinson, T., Epner, P., Shaheen, M., Pollock, A.M., et al. Primary care physicians’ challenges in ordering clinical laboratory tests and interpreting results. J. Am. Board Fam. Med. 27:2 (2014), 268–274, 10.3122/jabfm.2014.02.130104.
15. Hickner, J.M., Fernald, D.H., Harris, D.M., Poon, E.G., Elder, N.C., Mold, J.W., Issues and initiatives in the testing process in primary care physician offices. Jt. Comm. J. Qual. Patient Saf. 31:2 (2005), 81–89.
16. Lundberg, G.D., Acting on significant laboratory results. JAMA 245:17 (1981), 1762–1763, 10.1001/jama.1981.03310420052033.
17. Hickner, J., Graham, D.G., Elder, N.C., Brandt, E., Emsermann, C.B., Dovey, S., et al. Testing process errors and their harms and consequences reported from family medicine practices: a study of the American academy of family physicians national research network. Qual. Saf. Health Care 17:3 (2008), 194–200, 10.1136/qshc.2006.021915.
18. Gambino, S.R., Met and un met needs of the automated clinical laboratory. Trans. N.Y. Acad. Sci. 32:7 Series II (1970), 816–820, 10.1111/j.2164-0947.1970.tb02756.x.
19. Elder, N.C., Graham, D., Brandt, E., Dovey, S., Phillips, R., Ledwith, J., et al. The testing process in family medicine: problems, solutions and barriers as seen by physicians and their staff: a study of the American academy of family physicians’ national research network. J. Patient Saf. 2:1 (2006), 25–32.
20. Plebani, M., The detection and prevention of errors in laboratory medicine. Ann. Clin. Biochem. 47:Pt. 2 (2010), 101–110, 10.1258/acb.2009.009222 PubMed PMID: 19952034.
21. Hawkins, R., Managing the pre-and post-analytical phases of the total testing process. Ann. Lab. Med. 32:1 (2012), 5–16.
22. Casalino, L.P., Dunham, D., Chin, M.H., Bielang, R., Kistner, E.O., Karrison, T.G., et al. Frequency of failure to inform patients of clinically significant outpatient test results. Arch. Intern. Med. 169:12 (2009), 1123–1129, 10.1001/archinternmed.2009.130 PubMed PMID: 19546413.
23. Moore, C.R., No News May Not Be Good News. 2012, Agency for Healthcare Research and Quality (accessed May 25, 2016) https://psnet.ahrq.gov/webmm/case/275/no-news-may-not-be-good-news.
24. Piva, E., Pelloso, M., Penello, L., Plebani, M., Laboratory critical values: automated notification supports effective clinical decision making. Clin. Biochem. 47:13–14 (2014), 1163–1168, 10.1016/j.clinbiochem.2014.05.056.
25. Paré G., Trudel, M.-C., Jaana, M., Kitsiou, S., Synthesizing information systems knowledge: a typology of literature reviews. Inf. Manag. 52:2 (2015), 183–199.
26. Ortiz de Guinea, A., Paré G., What literature review type should i conduct?. Galliers, R.D., Stein, M.-K., (eds.) The Routledge Companion to Management Information Systems, 2017, Routledge, Taylor & Francis Group, Oxford, UK.
27. Paré G., Tate, M., Johnstone, D., Kitsiou, S., Contextualizing the twin concepts of systematicity and transparency in information systems literature reviews. Eur. J. Inf. Syst. 25:6 (2016), 493–508.
28. Etchells, E., Adhikari, N.K.J., Wu, R., Cheung, M., Quan, S., Mraz, R., et al. Real-time automated paging and decision support for critical laboratory abnormalities. BMJ Qual. Saf. 20:11 (2011), 924–930, 10.1136/bmjqs.2010.051110.
29. Georgiou, A., Vecellio, E., Toouli, G., Eigenstetter, A., Li, L., Wilson, R., et al. Monitoring the impact of the electronic medical record on the quality of laboratory test ordering practices. Stud. Health Technol. Inf. 188 (2013), 33–38 PubMed PMID: 23823285.
30. Jha, A.K., DesRoches, C.M., Campbell, E.G., Donelan, K., Rao, S.R., Ferris, T.G., et al. Use of electronic health records in US hospitals. New Engl. J. Med. 360:16 (2009), 1628–1638.
31. Deleger, L., Brodzinski, H., Zhai, H., Li, Q., Lingren, T., Kirkendall, E.S., et al. Developing and evaluating an automated appendicitis risk stratification algorithm for pediatric patients in the emergency department. J. Am. Med. Inform. Assoc. 20:e2 (2013), e212–20.
32. Harrison, J.P., McDowell, G.M., The role of laboratory information systems in healthcare quality improvement. Int. J. Health Care Qual. Assur. 21:7 (2008), 679–691, 10.1108/09526860810910159 PubMed PMID: 19055276.
33. Giardina, T.D., Callen, J., Georgiou, A., Westbrook, J.I., Greisinger, A., Esquivel, A., et al. Releasing test results directly to patients: a multisite survey of physician perspectives. Patient Educ. Couns. 98:6 (2015), 788–796.
34. Elder, N.C., Barney, K., “But what does it mean for me?” Primary care patients’ communication preferences for test results notification. Jt. Comm. J. Qual. Patient Saf. 38:4 (2012), 168–176.
35. Tu, K., Manuel, D., Lam, K., Kavanagh, D., Mitiku, T.F., Guo, H., Diabetics can be identified in an electronic medical record using laboratory tests and prescriptions. J. Clin. Epidemiol. 64:4 (2011), 431–435, 10.1016/j.jclinepi.2010.04.007.
36. Laxmisan, A., Sittig, D.F., Pietz, K., Espadas, D., Krishnan, B., Singh, H., Effectiveness of an electronic health record-based intervention to improve follow-up of abnormal pathology results: a retrospective record analysis. Med. Care 50:10 (2012), 898–904.
37. US Department of Health Human Services, National Institutes of Health National Heart Lung, and Blood Institute, Study Quality Assessment Tools. [January 10, 2018]. Available from: 2018 https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.
38. The Joanna Briggs Institute, The Joanna Briggs institute critical appraisal tools for use in JBI systematic reviews. Critical Appraisal Checklist for Qualitative Research, 2017 [January 10, 2018]. Available from: http://joannabriggs.org/research/critical-appraisal-tools.html.
39. Al Alawi, S., Al Dhaheri, A., Al Baloushi, D., Al Dhaheri, M., Prinsloo, E.A.M., Physician user satisfaction with an electronic medical records system in primary healthcare centres in Al Ain: a qualitative study. BMJ Open 4:11 (2014), e005569–e, 10.1136/bmjopen-2014-005569 PubMed PMID: 25377010.
40. Bell, D.S., Cima, L., Seiden, D.S., Nakazono, T.T., Alcouloumre, M.S., Cunningham, W.E., et al. Effects of laboratory data exchange in the care of patients with HIV. Int. J. Med. Inf. 81:10 (2012), e74–82, 10.1016/j.ijmedinf.2012.07.012 PubMed PMID: 104367597. Language: English. Entry Date: 20130208. Revision Date: 20161117. Publication Type: journal article.
41. Blaya, J.A., Shin, S., Contreras, C., Yale, G., Suarez, C., Asencios, L., et al. Full impact of laboratory information system requires direct use by clinical staff: cluster randomized controlled trial. J. Am. Med. Inform. Assoc. 18:1 (2011), 11–16, 10.1136/jamia.2010.005280.
42. Blaya, J.A., Shin, S.S., Yagui, M., Contreras, C., Cegielski, P., Yale, G., et al. Reducing communication delays and improving quality of care with a tuberculosis laboratory information system in resource poor environments: a cluster randomized controlled trial. PloS One, 9(4), 2014, e90110.
43. Bowie, P., Halley, L., McKay, J., Laboratory test ordering and results management systems: a qualitative study of safety risks identified by administrators in general practice. BMJ Open, 4(2), 2014, 10.1136/bmjopen-2013-004245.
44. Feldstein, A.C., Smith, D.H., Perrin, N., et al. Improved therapeutic monitoring with several interventions: a randomized trial. Arch. Intern. Med. 166:17 (2006), 1848–1854, 10.1001/archinte.166.17.1848.
45. Ferris, T.G., Johnson, S.A., Co, J.P., Backus, M., Perrin, J., Bates, D.W., et al. Electronic results management in pediatric ambulatory care: qualitative assessment. Pediatrics 123:Suppl. 2 (2009), S85–91.
46. Fischer, S., Tjia, J., Reed, G., Peterson, D., Gurwitz, J., Field, T., Factors associated with ordering laboratory monitoring of High-risk medications. J. Gen. Intern. Med. 29:12 (2014), 1589–1598, 10.1007/s11606-014-2907-9.
47. Gascon, F., Herrera, I., Vazquez, C., Jimenez, P., Jimenez, J., Real, C., et al. Electronic health record: design and implementation of a lab test request module. Int. J. Med. Inf. 82:6 (2013), 514–521.
48. Howard, J., Clark, E.C., Friedman, A., Crosson, J.C., Pellerano, M., Crabtree, B.F., et al. Electronic health record impact on work burden in small, unaffiliated, community-based primary care practices. J. Gen. Intern. Med. 28:1 (2013), 107–113.
49. Huck, D., Ginsberg, J.P., Gordon, S.M., Nowacki, A.S., Rehm, S.J., Shrestha, N.K., Association of laboratory test result availability and rehospitalizations in an outpatient parenteral antimicrobial therapy programme. J. Antimicrob. Chemother. 69:1 (2014), 228–233, 10.1093/jac/dkt303 PubMed PMID: 23887864.
50. King, J., Patel, V., Jamoom, E.W., Furukawa, M.F., Clinical benefits of electronic health record use: national findings. Health Serv. Res. 49:1 Pt. 2 (2014), 392–404.
51. Lin, J.J., Moore, C., Impact of an electronic health record on follow-up time for markedly elevated serum potassium results. Am. J. Med. Qual. 26:4 (2011), 308–314.
52. McAlearney, A.S., Robbins, J., Hirsch, A., Jorina, M., Harrop, J.P., Perceived efficiency impacts following electronic health record implementation: an exploratory study of an urban community health center network. Int. J. Med. Inf. 79:12 (2010), 807–816.
53. McCormick, D., Bor, D.H., Woolhandler, S., Himmelstein, D.U., Giving office-based physicians electronic access to patients’ prior imaging and lab results did not deter ordering of tests. Health Aff. 31:3 (2012), 488–496.
54. Murff, H.J., Gandhi, T.K., Karson, A.K., Mort, E.A., Poon, E.G., Wang, S.J., et al. Primary care physician attitudes concerning follow-up of abnormal test results and ambulatory decision support systems. Int. J. Med. Inf. 71:2–3 (2003), 137–149, 10.1016/S1386-5056(03)00133-3.
55. Singh, H., Thomas, E.J., Sittig, D.F., Wilson, L., Espadas, D., Khan, M.M., et al. Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain?. Am. J. Med. 123:3 (2010), 238–244, 10.1016/j.amjmed.2009.07.027.
56. Smith, D.H., Feldstein, A.C., Perrin, N.A., Yang, X., Rix, M.M., Raebel, M.A., et al. Improving laboratory monitoring of medications: an economic analysis alongside a clinical trial. Am. J. Managed Care 15:5 (2009), 281–289 PubMed PMID: 2010280053. Language: English. Entry Date: 20090828. Revision Date: 20091218. Publication Type: journal article.
57. Turner, H.E., Deans, K.A., Kite, A., Croal, B.L., The effect of electronic ordering on pre-analytical errors in primary care. Ann. Clin Biochem. 50:Pt 5 (2013), 485–488, 10.1177/0004563213494184 PubMed PMID: 23897109.
58. Urban, E., Ose, D., Joos, S., Szecsenyi, J., Miksch, A., Technical support and delegation to practice staff - status quo and (possible) future perspectives for primary health care in Germany. BMC Med. Inform. Decis. Mak., 12(1), 2012, 81, 10.1186/1472-6947-12-81 PubMed PMID.
59. West, D.R., James, K.A., Fernald, D.H., Zelie, C., Smith, M.L., Raab, S.S., Laboratory medicine handoff gaps experienced by primary care practices: a report from the shared networks of collaborative ambulatory practices and partners (SNOCAP). J. Am. Board Fam. Med. 27:6 (2014), 796–803, 10.3122/jabfm.2014.06.140015.
60. Singh, H., Classen, D.C., Sittig, D.F., Creating an oversight infrastructure for electronic health record-related patient safety hazards. J. Patient Saf. 7:4 (2011), 169–174, 10.1097/PTS.0b013e31823d8df0 PubMed PMID: 2011398597. Language: English. Entry Date: 20120217. Revision Date: 20120217. Publication Type: journal article. Journal Subset: Health Services Administration.
61. Tarkan, S., Plaisant, C., Shneiderman, B., Hettinger, A.Z., Reducing missed laboratory results: defining temporal responsibility, generating user interfaces for test process tracking, and retrospective analyses to identify problems. AMIA Annual Symposium Proceedings/AMIA Symposium 2011 (2011), 1382–1391.
62. Yackel, T.R., Embi, P.J., Unintended errors with EHR-based result management: a case series. J. Am. Med. Inform. Assoc. 17:1 (2010), 104–107.
63. Liebow, E.B., Derzon, J.H., Fontanesi, J., Favoretto, A.M., Baetz, R.A., Shaw, C., et al. Effectiveness of automated notification and customer service call centers for timely and accurate reporting of critical values: a laboratory medicine best practices systematic review and meta-analysis. Clin. Biochem. 45:13–14 (2012), 979–987, 10.1016/j.clinbiochem.2012.06.023.
64. OECD - Organisation for Economic Cooperation and Development, Draft OECD Guide to Measuring ICTs in the Health Sector. COM/DELSA/DSTI(2013)3/FINAL. 2013 (accessed 2015-05-05) http://www.oecd.org/health/health-systems/Draft-oecd-guide-to-measuring-icts-in-the-health-sector.pdf.
65. Archer, N., Fevrier-Thomas, U., Lokker, C., McKibbon, K.A., Straus, S.E., Personal health records: a scoping review. J. Am. Med. Inf. Assoc. 18:4 (2011), 515–522, 10.1136/amiajnl-2011-000105.
66. Campbell, B., Linzer, G., Dufour, D.R., Lab tests online and consumer understanding of laboratory testing. Clin. Chim. Acta 432 (2014), 162–165, 10.1016/j.cca.2013.09.028.
67. Callen, J., Giardina, T.D., Singh, H., Li, L., Paoloni, R., Georgiou, A., et al. Emergency physicians’ views of direct notification of laboratory and radiology results to patients using the internet: a multisite survey. J. Med. Internet Res. 17:3 (2015), e60–e, 10.2196/jmir.3721 PubMed PMID: 25739322.
68. Asan, O., Young, H.N., Chewning, B., Montague, E., How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care. Patient Educ Couns. 98:3 (2015), 310–316, 10.1016/j.pec.2014.11.024.
69. Probst, C.A., Shaffer, V.A., Chan, Y.R., The effect of defaults in an electronic health record on laboratory test ordering practices for pediatric patients. Health Psychol. 32:9 (2013), 995–1002.
70. Horn, D.M., Koplan, K.E., Senese, M.D., Orav, E.J., Sequist, T.D., The impact of cost displays on primary care physician laboratory test ordering. J. Gen. Intern. Med. 29:5 (2014), 708–714, 10.1007/s11606-013-2672-1 PubMed PMID: 24257964.
71. Snyder, S.R., Favoretto, A.M., Derzon, J.H., Christenson, R.H., Kahn, S.E., Shaw, C.S., et al. Effectiveness of barcoding for reducing patient specimen and laboratory testing identification errors: a laboratory medicine best practices systematic review and meta-analysis. Clin. Biochem. 45:13–14 (2012), 988–998, 10.1016/j.clinbiochem.2012.06.019.
72. Walker, J., Pan, E., Johnston, D., Adler-Milstein, J., The value of health care information exchange and interoperability. Health Aff., 24, 2005, W5.
73. Williams, C., Mostashari, F., Mertz, K., Hogin, E., Atwal, P., From the office of the national coordinator: the strategy for advancing the exchange of health information. Health Aff. 31:3 (2012), 527–536, 10.1377/hlthaff.2011.1314.
74. US Department of Health Human Services, Health Information Technology for Economic and Clinical Health (HITECH) Act. Available at, 2009 https://www.healthit.gov/sites/default/files/hitech_act_excerpt_from_arra_with_index.pdf.
75. National Health Services, (NHS) England. Interoperability - The Open API Policy. [April 20, 2018]. Available from: 2014 https://www.england.nhs.uk/digitaltechnology/info-revolution/interoperability/open-api/.
76. Field, T.S., Garber, L., Gagne, S.J., Tjia, J., Preusse, P., Donovan, J.L., et al. Technological resources and personnel costs required to implement an automated alert system for ambulatory physicians when patients are discharged from hospitals to home. Inf. Prim. Care 20:2 (2012), 87–93 PubMed PMID: 23710773.
77. Kim, J.Y., Kamis, I.K., Singh, B., Batra, S., Dixon, R.H., Dighe, A.S., Implementation of computerized add-on testing for hospitalized patients in a large academic medical center. Clin. Chem. Lab. Med. 49:5 (2011), 845–850, 10.1515/CCLM.2011.140 PubMed PMID: 21303296.