Electronic Health Record Transition and Impact on Screening Test Follow-Up.

Area of Science:

• Medical Informatics
• Health Services Research
• Clinical Diagnostics

Background:

• Nonurgent clinically significant test results (CSTRs) are a frequent source of diagnostic delays.
• The impact of electronic health record (EHR) transitions on CSTR follow-up remains understudied.

Purpose of the Study:

• To investigate the effect of an EHR transition on follow-up rates for three specific CSTRs: incidental pulmonary nodules (IPNs), prostate-specific antigen (PSA) tests, and Pap smears.

Main Methods:

• Retrospective cohort study utilizing an interrupted time series (ITS) design.
• Assessed monthly follow-up rates for IPNs, PSA tests, and Pap smears before and after EHR transition at an urban tertiary medical center.
• Defined follow-up based on specific clinical actions within defined timeframes for each test type.

Main Results:

• No significant changes in follow-up rates were observed for IPNs or Pap smears post-EHR transition.
• A significant decreasing trend in PSA test follow-up was identified in the pre-EHR transition period.
• The EHR transition significantly altered the trend for PSA test follow-up, reversing the pre-existing decline.

Conclusions:

• EHR transitions can positively influence the follow-up of specific CSTRs, such as PSA tests, by mitigating declining trends.
• The impact of EHR transitions on CSTR follow-up may vary depending on the specific type of test evaluated.
• Further research is needed to understand the differential effects of EHR implementations on clinical test result management.