ArticleApplied clinical informatics2016
Workarounds and Test Results Follow-up in Electronic Health Record-Based Primary Care.
Article in Applied clinical informatics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 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
- 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
- "Most of what I do is a workaround now": Clinician Use of Workarounds Following an EHR Transition.Journal of general internal medicine · 2026Article
- Validation of an Algorithm to Classify Urine Cultures in Family Medicine.Applied clinical informatics · 2025Article
- Article
- Exploring the association between primary care efficiency and health system characteristics across European countries: a two-stage data envelopment analysis.BMC health services research · 2023Article
- Electronic Health Records' Support for Primary Care Physicians' Situation Awareness: A Metanarrative Review.Human factors · 2023Review
- Electronic Co-design (ECO-design) Workshop for Increasing Clinician Participation in the Design of Health Services Interventions: Participatory Design Approach.JMIR human factors · 2022Article
- Providers Electing to Receive Electronic Result Notifications: Demographics and Motivation.Applied clinical informatics · 2022Article
- Workarounds in Electronic Health Record Systems and the Revised Sociotechnical Electronic Health Record Workaround Analysis Framework: Scoping Review.Journal of medical Internet research · 2022Article
- Why Test Results Are Still Getting "Lost" to Follow-up: a Qualitative Study of Implementation Gaps.Journal of general internal medicine · 2022Article
- Why Is the Electronic Health Record So Challenging for Research and Clinical Care?Methods of information in medicine · 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
- How coping can hide larger systems problems: the routine immunisation supply chain in Bihar, India.BMJ global health · 2019Article
- Semiautomated System for Nonurgent, Clinically Significant Pathology Results.Applied clinical informatics · 2018Article
- Workarounds Emerging From Electronic Health Record System Usage: Consequences for Patient Safety, Effectiveness of Care, and Efficiency of Care.JMIR human factors · 2017Article
- Variation in the Management of Test Results after Hospital Discharge: A Pediatric Safety Concern.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundElectronic health records (EHRs) have potential to facilitate reliable communication and follow-up of test results. However, limitations in EHR functionality remain, leading practitioners to use workarounds while managing test results. Workarounds can lead to patient safety concerns and signify indications as to how to build better EHR systems that meet provider needs.
objectiveTo understand why primary care practitioners (PCPs) use workarounds to manage test results by analyzing data from a previously conducted national cross-sectional survey on test result management.
methodsWe conducted a secondary data analysis of quantitative and qualitative data from a national survey of PCPs practicing in the Department of Veterans Affairs (VA) and explored the use of workarounds in test results management. We used multivariate logistic regression analysis to examine the association between key sociotechnical factors that could affect test results follow-up (e.g., both technology-related and those unrelated to technology, such as organizational support for patient notification) and workaround use. We conducted a qualitative content analysis of free text survey data to examine reasons for use of workarounds.
resultsOf 2554 survey respondents, 1104 (43%) reported using workarounds related to test results management. Of these 1028 (93%) described the type of workaround they were using; 719 (70%) reported paper-based methods, while 230 (22%) used a combination of paper- and computer-based workarounds. Primary care practitioners who self-reported limited administrative support to help them notify patients of test results or described an instance where they personally (or a colleague) missed results, were more likely to use workarounds (p=0.02 and p=0.001, respectively). Qualitative analysis identified three main reasons for workaround use: 1) as a memory aid, 2) for improved efficiency and 3) for facilitating internal and external care coordination.
conclusionWorkarounds to manage EHR-based test results are common, and their use results from unmet provider information management needs. Future EHRs and the respective work systems around them need to evolve to meet these needs.
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