Test result management in global health settings

Area of Science:

• Health Informatics
• Clinical Management
• Patient Outcomes

Background:

• Healthcare systems globally exhibit varied approaches to managing patient test results.
• A common outcome is the failure to adequately follow up on clinically significant test results, leading to adverse patient events.
• Both paper-based and electronic medical record (EMR) systems present challenges in ensuring timely access and action on test results.

Purpose of the Study:

• To highlight the critical issue of missed or delayed follow-up on patient test results.
• To examine the systemic failures in test result management across different healthcare settings.
• To underscore the need for improved systems to prevent adverse patient outcomes due to unaddressed test results.

Main Methods:

• The study reviews common challenges in test result management across various healthcare delivery models.
• It analyzes the limitations of both paper-based records and current electronic medical record (EMR) systems in facilitating result follow-up.
• A case vignette of an HIV diagnosis in three distinct settings illustrates the problem.

Main Results:

• Clinically significant test results frequently "fall through the cracks" regardless of the healthcare system.
• Resource-poor settings often isolate results in paper charts, burdening patients with retrieval.
• Even advanced electronic medical records (EMRs) can present static data, hindering easy access and sharing of critical test results.

Conclusions:

• Current methods of managing patient test results are inadequate, leading to significant patient harm.
• Electronic medical records (EMRs) alone have not solved the problem of test result follow-up.
• Systemic improvements are necessary to ensure timely and effective management of all patient test results.