Éric Maillet1, Guy Paré2, Leanne M Currie3, Louis Raymond4, Ana Ortiz de Guinea5, Marie-Claude Trudel6, Josianne Marsan7. 1. Faculty of Medicine and Health Sciences, School of Nursing, University of Sherbrooke, 150, place Charles-Le Moyne, Longueuil, Québec, Canada, J4K 0A8. Electronic address: eric.maillet@usherbrooke.ca. 2. Information Technology Department, HEC Montréal, Montréal, Québec, Canada. Electronic address: guy.pare@hec.ca. 3. School of Nursing University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: leanne.currie@ubc.ca. 4. Institut de recherche sur les PME, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada. Electronic address: louis.Raymond@uqtr.ca. 5. Information Technology Department, HEC Montréal, Montréal, Québec, Canada; Department of Strategy and Information Systems Deusto Business School, Universidad de Deusto (Spain). Electronic address: ana.ortiz-de-guinea@hec.ca. 6. Information Technology Department, HEC Montréal, Montréal, Québec, Canada. Electronic address: marie-claude.trudel@hec.ca. 7. Department of Management Information Systems, Université Laval, Québec, Canada. Electronic address: josianne.marsan@sio.ulaval.ca.
Abstract
INTRODUCTION: Laboratory testing in primary care is a fundamental process that supports patient management and care. Any breakdown in the process may alter clinical information gathering and decision-making activities and can lead to medical errors and potential adverse outcomes for patients. Various information technologies are being used in primary care with the goal to support the process, maximize patient benefits and reduce medical errors. However, the overall impact of health information technologies on laboratory testing processes has not been evaluated. OBJECTIVES: To synthesize the positive and negative impacts resulting from the use of health information technology in each phase of the laboratory 'total testing process' in primary care. METHODS: We conducted a systematic review. Databases including Medline, PubMed, CINAHL, Web of Science and Google Scholar were searched. Studies eligible for inclusion reported empirical data on: 1) the use of a specific IT system, 2) the impacts of the systems to support the laboratory testing process, and were conducted in 3) primary care settings (including ambulatory care and primary care offices). Our final sample consisted of 22 empirical studies which were mapped to a framework that outlines the phases of the laboratory total testing process, focusing on phases where medical errors may occur. RESULTS: Health information technology systems support several phases of the laboratory testing process, from ordering the test to following-up with patients. This is a growing field of research with most studies focusing on the use of information technology during the final phases of the laboratory total testing process. The findings were largely positive. Positive impacts included easier access to test results by primary care providers, reduced turnaround times, and increased prescribed tests based on best practice guidelines. Negative impacts were reported in several studies: paper-based processes employed in parallel to the electronic process increased the potential for medical errors due to clinicians' cognitive overload; systems deemed not reliable or user-friendly hampered clinicians' performance; and organizational issues arose when results tracking relied on the prescribers' memory. DISCUSSION: The potential of health information technology lies not only in the exchange of health information, but also in knowledge sharing among clinicians. This review has underscored the important role played by cognitive factors, which are critical in the clinician's decision-making, the selection of the most appropriate tests, correct interpretation of the results and efficient interventions. CONCLUSIONS: By providing the right information, at the right time to the right clinician, many IT solutions adequately support the laboratory testing process and help primary care clinicians make better decisions. However, several technological and organizational barriers require more attention to fully support the highly fragmented and error-prone process of laboratory testing.
INTRODUCTION: Laboratory testing in primary care is a fundamental process that supports patient management and care. Any breakdown in the process may alter clinical information gathering and decision-making activities and can lead to medical errors and potential adverse outcomes for patients. Various information technologies are being used in primary care with the goal to support the process, maximize patient benefits and reduce medical errors. However, the overall impact of health information technologies on laboratory testing processes has not been evaluated. OBJECTIVES: To synthesize the positive and negative impacts resulting from the use of health information technology in each phase of the laboratory 'total testing process' in primary care. METHODS: We conducted a systematic review. Databases including Medline, PubMed, CINAHL, Web of Science and Google Scholar were searched. Studies eligible for inclusion reported empirical data on: 1) the use of a specific IT system, 2) the impacts of the systems to support the laboratory testing process, and were conducted in 3) primary care settings (including ambulatory care and primary care offices). Our final sample consisted of 22 empirical studies which were mapped to a framework that outlines the phases of the laboratory total testing process, focusing on phases where medical errors may occur. RESULTS: Health information technology systems support several phases of the laboratory testing process, from ordering the test to following-up with patients. This is a growing field of research with most studies focusing on the use of information technology during the final phases of the laboratory total testing process. The findings were largely positive. Positive impacts included easier access to test results by primary care providers, reduced turnaround times, and increased prescribed tests based on best practice guidelines. Negative impacts were reported in several studies: paper-based processes employed in parallel to the electronic process increased the potential for medical errors due to clinicians' cognitive overload; systems deemed not reliable or user-friendly hampered clinicians' performance; and organizational issues arose when results tracking relied on the prescribers' memory. DISCUSSION: The potential of health information technology lies not only in the exchange of health information, but also in knowledge sharing among clinicians. This review has underscored the important role played by cognitive factors, which are critical in the clinician's decision-making, the selection of the most appropriate tests, correct interpretation of the results and efficient interventions. CONCLUSIONS: By providing the right information, at the right time to the right clinician, many IT solutions adequately support the laboratory testing process and help primary care clinicians make better decisions. However, several technological and organizational barriers require more attention to fully support the highly fragmented and error-prone process of laboratory testing.
Authors: Sharon L Cadogan; John P Browne; Colin P Bradley; Anthony P Fitzgerald; Mary R Cahill Journal: Br J Gen Pract Date: 2020-01-30 Impact factor: 5.386
Authors: Lorcan Clarke; Michael Anderson; Rob Anderson; Morten Bonde Klausen; Rebecca Forman; Jenna Kerns; Adrian Rabe; Søren Rud Kristensen; Pavlos Theodorakis; Jose Valderas; Hans Kluge; Elias Mossialos Journal: Milbank Q Date: 2021-09-02 Impact factor: 4.911