Improving communication between providers, diagnostic testing and medication tracking, and documentation through health IT use can help to reduce delayed, missed, and incorrect diagnoses.
This set of safe health IT use recommendations was released as part of ECRI’s Partnership for Health IT Patient Safety collaborative, which was established in 2014. The multi-stakeholder partnership is open to participation from providers, health IT companies, professional organizations, and other industry insiders.
The partnership’s most recent workgroup focused on improving patient safety during diagnostic testing, test tracking, and medication changes. Chaired by Vanderbilt University professor of pediatrics and biomedical informatics professor Christoph Lehmann, MD, the group identified three strategies healthcare organizations should keep in mind when implementing health IT solutions.
In combination, these three strategies can be effective in closing the loop of patient diagnoses.
“The goal of this Partnership workgroup was to look for technology solutions that all stakeholders could implement to close the loop — the tools provided here will help to do just that,” said ECRI Institute Program Director Lorraine Possanza.
First, the workgroup emphasized the importance of developing and applying health IT solutions that will communicate the necessary information to the correct members of a patient’s care team at the right time.
“Improve the transmission of information using standards for the formatting of normal, critical, abnormal-noncritical, and abnormal results,” wrote members of the workgroup in the report.
Efficient and effective communication between testing facilities, pharmacies, providers, and patients can enhance patient care across care settings, ECRI suggested.
“Designing, testing, deploying, and implementing health IT solutions to improve these communication pathways has the potential to make closing the loop a seamless and elegant process, with all diagnostic results and medications communicated to the provider, the pharmacy, and the patient,” wrote the workgroup.
ECRI also emphasized the importance of tracking diagnostic results and medication changes.
“Tracking of diagnostic results and medication changes is a time-consuming, burdensome task, but necessary to ensure a closed loop,” noted report authors. “Identification of interruptions and potential failure points in the process is critical to find and react to failures to close the loop.”
The workgroup recommended healthcare organizations identify where health IT can be useful for resolving deficiencies and improving medication and test result tracking.
Using EHR functionality to track diagnostic testing and medication changes may also be helpful. Furthermore, implementing lab standards — such as LOINC — may help to automate accurate matching of results and ordered tests to close loops.
Finally, ECRI suggested healthcare organizations use health IT to link, acknowledge, and document the review of information and action taken.
“This step includes the actor reviewing and acknowledging or acting upon information,” clarified report authors.
Toward this end, the workgroup recommended healthcare organizations help to improve interoperability by integrating EHR systems and other health IT modules across the care continuum to facilitate communication and documentation across care settings.
“This is to facilitate communication and acknowledgment, including the use of application programming interfaces (APIs) to allow laboratory systems and hospitals to communicate, as well as the use of HL7 and fast healthcare interoperability resources (FHIR) to aggregate and merge patient data from separate data sources,” wrote the workgroup.
Developing EHR functionality such as diagnostic results notifications may help to promote communication, acknowledgement, and documentation of diagnostic testing, medication changes, and actions taken.
Implementing these health IT use practices and closing the loop will help to avoid delayed or missed diagnoses, which may lead to patient harm.
“These safe practice recommendations are a call to action,” maintained the workgroup. “Although the EHR and its technology components have the potential to facilitate timely follow-up across all healthcare settings, it may take regulatory efforts to make this possible.”