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Published on: August 1, 2019
Electronic Trigger-Based Intervention to Reduce Delays in Diagnostic Evaluation for Cancer: A Cluster Randomized
Daniel R Murphy1, Louis Wu1, Eric J Thomas1
1Daniel R. Murphy, Louis Wu, Ashley N.D. Meyer, and Hardeep Singh, Houston Veterans Affairs Health Services Research and Development, Michael E. DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Baylor College of Medicine; Eric J. Thomas, University of Texas Houston Medical School and University of Texas Houston-Memorial Hermann Center for Healthcare Quality and Safety, Houston; and Samuel N. Forjuoh, Scott and White Healthcare, Texas A&M Health Science Center, College of Medicine, Temple, TX.
Electronic health record (EHR) triggers can reduce diagnostic delays for colorectal and prostate cancer. This study shows prospective EHR-based algorithms improve timely cancer diagnosis and follow-up care.
Area of Science:
- Oncology
- Health Informatics
- Primary Care
Background:
- Diagnostic delays in cancer care can negatively impact patient outcomes.
- Electronic health records (EHRs) offer potential for identifying at-risk patients proactively.
Purpose of the Study:
- To evaluate the effectiveness of EHR-based trigger algorithms in preventing diagnostic delays for cancer.
- To assess if prospective identification of high-risk patients reduces time to diagnostic evaluation.
Main Methods:
- A cluster randomized controlled trial involving primary care providers (PCPs) was conducted.
- EHR triggers identified patients with abnormal findings and lacking follow-up actions.
- Intervention involved communicating high-risk alerts to PCPs to ensure timely diagnostic evaluation.
Main Results:
- The intervention significantly reduced time to diagnostic evaluation for colorectal and prostate cancer.
- Colorectal cancer evaluation time decreased from 200 to 104 days; prostate cancer evaluation improved by 40%.
- Overall, 73.4% of intervention patients received diagnostic evaluation compared to 52.2% in the control group.
Conclusions:
- EHR-based trigger interventions are effective in reducing diagnostic delays for colorectal and prostate cancer.
- These interventions improve the rate of follow-up diagnostic evaluations for cancer patients.
- Similar strategies may enhance the timeliness of diagnoses for other serious health conditions.
