Physicians are aware of approximately 40% of the final results of tests pending at discharge (TPADs). Few institutions have standardized systems to manage TPADs. Automated systems using “push” notification may improve awareness of TPADs; however, successful development and implementation are dependent on integration with inpatient work flow and clinical information systems, and an understanding of institutional culture.
To develop an automated e‐mail system to notify responsible physicians of the finalized results of TPADs for patients discharged from Brigham and Women's Hospital.
The service (1) is triggered by the time the patient is removed from the inpatient bed management system, (2) identifies the e‐mail addresses of the inpatient attending at the time of discharge and the patient's primary care provider (PCP) from administrative databases, (3) files all nonfi‐nalized tests in a queue, (4) updates the status of nonfinalized tests at midnight each day, and (5) sends an e‐mail of the patients’ result(s) to the inpatient attending (with a copy sent to the PCP) when newly finalized results are available. We built a user interface to activate the system for specific physicians, clinical services, and test types. To minimize alert fatigue, we incorporated logic to suppress certain tests and to limit physician notifications to no more than 1 e‐mail per patient per day until all TPADs are finalized. We monitored our system's performance from October 26, 2010, through November 30, 2010, during which it was activated for chemistry and hematology test types and for the responsible physicians of patients discharged from general medicine and cardiology services.
For 82 discharged patients, the system automatically detected 264 chemistry and 141 hematology TPADs (4.9 per patient) and triggered a total of 136 emails (1.7 per patient). The system triggered 2 or more emails to physicians for 28 discharged patients (34%) whose results were finalized on different days. The system reported 73 abnormal results (18%) in e‐mails sent to responsible physicians. The system erroneously triggered notification emails on 1 patient (1.2%). A sample of the types of chemistry and hematology test results reported in e‐mails are listed in Table 1. Automated e‐mail notification is a plausible and reliable approach for notifying inpatient physicians of the finalized results of TPADs in a manner compatible with their work flow. We plan to activate and test this service for radiology, pathology, and microbiology results, as well as additional inpatient services in January 2011.
A. Dalal ‐ none; J. Schnipper ‐ none; E. Poon ‐ none; K. Rossi‐Roh ‐ none; A. Macleay ‐ none; D. Williams ‐ none; C. Liang ‐ none; J. Budris ‐ none; C. Roy ‐ none
To cite this abstract:Dalal A, Schnipper J, Poon E, Rossi‐Roh K, Macleay A, Williams D, Liang C, Budris J, Roy C. Design and Implementation of an Automated E‐Mail Notification System for Results of Tests Pending at Discharge. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 164. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/design-and-implementation-of-an-automated-email-notification-system-for-results-of-tests-pending-at-discharge/. Accessed March 31, 2020.