ArticleBMJ open2014
How context affects electronic health record-based test result follow-up: a mixed-methods evaluation.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Communicating blood test results in primary care: a mixed-methods systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Pooled it
- Defining and assessing context in healthcare implementation studies: a systematic review.BMC health services research · 2020Pooled it
- The impact of health information technology on the management and follow-up of test results - a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2019Pooled it
- A Virtual Breakthrough Series Collaborative for Missed Test Results: A Stepped-Wedge Cluster-Randomized Clinical Trial.JAMA network open · 2024Trial
- Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.Journal of general internal medicine · 2017Trial
- Mapping colorectal cancer screening workflows in primary care.BMJ public health · 2026Article
- Exploring the implemented guidelines for dyslipidemia treatment and care among nurses and physicians: A qualitative study in Jordan.PloS one · 2025Article
- Management of the Electronic Health Record Inbox: Results From a National Survey of Internal Medicine Program Directors.Journal of graduate medical education · 2023Article
- Examining perspectives on the adoption and use of computer-based patient-reported outcomes among clinicians and health professionals: a Q methodology study.Journal of the American Medical Informatics Association : JAMIA · 2022Review
- Why Test Results Are Still Getting "Lost" to Follow-up: a Qualitative Study of Implementation Gaps.Journal of general internal medicine · 2022Article
- Identifying the mechanisms that contribute to safe and effective electronic test result management systems- a multisite qualitative study.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Variation in electronic test results management and its implications for patient safety: A multisite investigation.Journal of the American Medical Informatics Association : JAMIA · 2020Article
- Factors influencing digital review of pathology test results in an inpatient setting: a cross-sectional study.JAMIA open · 2020Article
- Assessment of Health Information Technology-Related Outpatient Diagnostic Delays in the US Veterans Affairs Health Care System: A Qualitative Study of Aggregated Root Cause Analysis Data.JAMA network open · 2020Article
- Measures to Improve Diagnostic Safety in Clinical Practice.Journal of patient safety · 2019Article
- Oncologists' Perceptions of a Digital Tool to Improve Cancer Survivors' Cardiovascular Health.ACI open · 2019Article
- Impact of a national QI programme on reducing electronic health record notifications to clinicians.BMJ quality & safety · 2019Article
- Test Result Management Practices of Canadian Internal Medicine Physicians and Trainees.Journal of general internal medicine · 2019Article
- Challenges in Communication from Referring Clinicians to Pathologists in the Electronic Health Record Era.Journal of pathology informatics · 2018Article
- Assigning responsibility to close the loop on radiology test results.Diagnosis (Berlin, Germany) · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesElectronic health record (EHR)-based alerts can facilitate transmission of test results to healthcare providers, helping ensure timely and appropriate follow-up. However, failure to follow-up on abnormal test results (missed test results) persists in EHR-enabled healthcare settings. We aimed to identify contextual factors associated with facility-level variation in missed test results within the Veterans Affairs (VA) health system. DESIGN, SETTING AND
participantsBased on a previous survey, we categorised VA facilities according to primary care providers' (PCPs') perceptions of low (n=20) versus high (n=20) risk of missed test results. We interviewed facility representatives to collect data on several contextual factors derived from a sociotechnical conceptual model of safe and effective EHR use. We compared these factors between facilities categorised as low and high perceived risk, adjusting for structural characteristics.
resultsFacilities with low perceived risk were significantly more likely to use specific strategies to prevent alerts from being lost to follow-up (p=0.0114). Qualitative analysis identified three high-risk scenarios for missed test results: alerts on tests ordered by trainees, alerts 'handed off' to another covering clinician (surrogate clinician), and alerts on patients not assigned in the EHR to a PCP. Test result management policies and procedures to address these high-risk situations varied considerably across facilities.
conclusionsOur study identified several scenarios that pose a higher risk for missed test results in EHR-based healthcare systems. In addition to implementing provider-level strategies to prevent missed test results, healthcare organisations should consider implementing monitoring systems to track missed test results.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.