An interventional study of Email Notification in Test Result Management, sponsored by Brigham and Women's Hospital. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2013-06-05.
Sponsored by Brigham and Women's Hospital · Not applicable, Interventional, and Health services research
Specific Aims: (Study #1, funded by AHRQ, completed May 2011)
Hypothesis: Automatic email notification will improve physician awareness of test results finalized after discharge compared to usual care.
Specific Aims: (Study #2, funded by CRICO, completed July 2012)
Hypothesis: Automated email notification of the finalized results of potentially actionable TPADs increases the rate of actions taken post-discharge.
Failure to follow up on abnormal test results is a critical problem and is more likely to occur in the case of tests that are performed in the hospital but whose results are not available or not finalized until after discharge (i.e., pending test results). Responsible inpatient and ambulatory providers may not be aware of these test results. In a prior study, Roy et al. determined that 41% of patients were discharged before all laboratory, microbiology, and radiology test results were finalized (31% were collectively hematology, chemistry, and pathology tests, 27% were radiology studies, and 42% were microbiology results). Of these results, 9.4% were considered potentially actionable by independent physician review and could have altered the post-discharge patient care plan. Physicians were only aware of 38% of these test results. Failure to follow-up on these test results can lead to delays in diagnosis, missed treatment opportunities, redundant ordering of tests, and subsequent patient harm. In a hospital the size of Brigham and Women's Hospital (BWH) with 44,000 annual admissions, physicians would be unaware of almost 2000 actionable test results per year. Automated systems can mitigate this problem by ensuring prompt notification of relevant test results finalized after discharge to responsible inpatient and ambulatory providers. Using internal BWH funding, we have developed an automated email notification system to facilitate management of tests pending at discharge (TPADs).
In study 1 (funded by AHRQ), we will prospectively evaluate the impact of this intervention on physician awareness of TPAD results. In study 2 (funded by CRICO), we will perform a chart review to determine the impact of the intervention on downstream actions taken by physicians and acknowledgment of TPAD results as documented in the electronic medical record.
Brigham and Women's Hospital is the lead sponsor of 1,263 studies on the registry; 225 are open to participants now.
Of its 116 completed or terminated interventional studies of FDA-regulated products, 65 (56%) have results posted.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Responsible inpatient and ambulatory physicians assigned to usual care will not receive any email(s) of patients' test results generated from the notification system.
Responsible inpatient and ambulatory physicians will receive automated email(s) of patients' tests results finalized post-discharge generated from the notification system. Finalized results will be batched such that no provider will receive more than one email per day.
Other: Email Notification
BWH inpatient clinical information systems will automatically file all non-finalized chemistry, hematology, pathology, and radiology tests, as well as inpatient and ambulatory provider email addresses for all study patients discharged. This process will be initiated using a time stamp most proximate to actual discharge time. At midnight on every day, all tests filed at time of discharge will be updated if final results have become available. An email with all finalized and pending test results for each patient discharged will be sent to the inpatient and primary care provider at this time. For patients discharged with more than one pending test, subsequent email notification(s) will be sent out until all pending tests are finalized (no more than one email per day).
Percent of Inpatient Providers Aware of Finalized Results of Tests Pending at Discharge (Study 1)
The primary outcome will be the percentage of inpatient physicians who are aware of the finalized results of tests pending at discharge.
Time frame: 72 hours after notification, October 2010 thru May 2011
Percent of Ambulatory Providers Aware of Finalized Results of Tests Pending at Discharge (Study 1)
Secondary outcomes will include the percentage of ambulatory physicians who are aware of the finalized results of tests pending at discharge (both Partners network and non-network providers).
Time frame: 72 hours after notification, October 2010 thru May 2011
Percent of Providers Aware of Actionable Test Results (Study 1)
Percent awareness of actionable test results by responsible providers
Time frame: 72 hours after notification, October 2010 thru May 2011
Provider Satisfaction (Study 1)
Percentage of providers satisfied with the notification system.
Time frame: 72 hours after notification, October 2010 thru May 2011
Proportion of potentially actionable TPAD results with documented action(s) taken in the intervention versus control arms. (Primary Outcome, Study 2)
The primary outcome will be measured as the difference in the proportion of potentially actionable TPAD results with documented actions taken (as determined by electronic chart review) per discharged patient in the intervention and control arm.
Time frame: Retrospective chart data abstraction for patients discharged from July 2011 through July 2012
Proportion of potentially actionable TPAD results with documented acknowledgement in the intervention versus control arms. (Secondary Outcome, Study 2)
The secondary outcome will be measured as the difference in the proportion of potentially actionable TPAD results with documented acknowledgment (as determined by electronic chart review) in the intervention and control arm.
Time frame: Retrospective chart data abstraction for patients discharged from July 2011 through July 2012
The record gives a start of Oct 2010, a primary completion of May 2011 and a completion of Jul 2012. It does not say whether these dates are actual or estimated.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jun 2013. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Brigham and Women's Hospital →