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I just wanted to thank everyone who responded to my query, either directly or via the mailbase. Some very useful comments and suggestions were put forward and will form the basis of the follow-up work we will be doing in this area. I was aware of the 2001 paper by Eric Kilpatrick and this was the main stimulus for our examination of our electronic reporting (once we had the IT systems in place) and it is interesting to see how similar the figures are. Our next step is to clarify with the software provider (Indigo) whether reports can be viewed without the audit trail capturing it (ie via cumulative reports) or whether they may be accessed via other sources - phone calls, paper etc. I also need to clarify the degree of 'push' that we give reports and how acceptable this is to our users. Thanks again to all for your comments - much appreciated. Kind regards Louise Louise Tilbrook Principal Clinical Scientist Dept of Clinical Biochemistry Mid Essex Hospitals NHS Trust Chelmsford CM1 7ET 01245 515036 07919 016847 ________________________________ From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Waise Ahmed (York Hospitals NHS Foundation Trust) Sent: 28 July 2009 08:35 To: [log in to unmask] Subject: Re: Viewing of electronic reports I wonder if anyone has asked the requestors themselves what they actually would like to see and when? Our GPs are only interested in 'flagged results’. Within the hospital I think reporting urgent results that need phoning is separate from routine ones. A system similar to the one in primary care where GPs sign off reports on line would be an option but hospital users are not keen and also introduces CG issues as users do not tend to log off as a routine after use. rgds A Ahmed Waise FRCP FRCPath Consultant Chemical Pathologist Laboratory Medicine & Centre for Diabetes and Endocrinology York Hospital, YORK YO31 8HE ________________________________ From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Jonathan Kay [[log in to unmask]] Sent: 27 July 2009 19:09 To: [log in to unmask] Subject: Re: Viewing of electronic reports Agreed. This is is the point I was making about "pushiness"... unfortunately early CRS users in England are reporting mailbox overload in those rather pushy systems... Jonathan On 27 Jul 2009, at 17:09, Eric Kilpatrick wrote: As Rick says, this seems to be an endemic feature of electronic reporting and little seems to have changed since we reported similar findings from data collected a decade ago. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=gateway&pubmedid=11337442 I would love to see a system that, rather than needing to actively look up data on a patient to see if the result is through (assuming you know they have had a test done in the first place), appears like an email inbox showing the number of unread results. Eric Professor E S Kilpatrick Department of Clinical Biochemistry Hull Royal Infirmary Anlaby Road Hull HU3 2JZ Tel 01482-607708 Fax 01482-607752 ________________________________ Date: Thu, 23 Jul 2009 14:53:34 +0100 From: [log in to unmask]<mailto:[log in to unmask]> Subject: Re: Viewing of electronic reports To: [log in to unmask]<mailto:[log in to unmask]> This seems to be about the norm. On our web repository, which accepts diagnostic results from radiology, endoscopy as well as all pathology disciplines, the average look up rate is 58% and has been at that level consistently for 2-3 years. We know that many of the paper reports are not filed judging from discussions amongst the clinical teams. The impact on clinical care has not been quantified or costed but would make for an interesting and challenging research project. We also know that telephone enquiries are not making up the difference as we don’t receive that many calls and wouldn’t have the staff to cope if we did. There is currently interest centrally in working up methods to ensure that result receipt and actions can be acknowledged electronically. I am sure there will be opportunities for the ACB to contribute to that work as it develops. Rick Jones ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Cathryn Corns Sent: 23 July 2009 11:16 To: [log in to unmask]<mailto:[log in to unmask]>; Richard Jones [Pathology] Subject: Re: Viewing of electronic reports Louise I think that this is not unusual, but when I tried to audit this I discovered a problem. The ICE reporting system we use suggested that about half the reports were never reviewed, but when I looked in more detail I found that the audit trail on ICE only showed whether the most recent report had been viewed. An interim report could have been viewed but this part of the audit trail was then overwritten by a later report which would appear as 'not viewed' on the audit trail. Only by unlocking and showing ALL the previous reports could I find whether the report had ever been viewed. When I did this (and it was very tedious!) I found that most reports had been viewed at some point. What had not been viewed were things like TFTs, haematinics etc which took longer to be reported. If your system operates in the same way you may have to do a bit more digging in the audit trail! Cathryn Cathryn Corns Head of Biochemistry Department 01702 435555 ext 6614 ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Tilbrook Louise (Mid Essex Hospital Services NHS Trust) Sent: 21 July 2009 17:14 To: [log in to unmask]<mailto:[log in to unmask]> Subject: Viewing of electronic reports Our Trust recently moved to electronic order comms requesting for in-patients and we have just been reviewing the first few months data. One notable finding is the high proportion of reports which are not viewed/accessed - over 50% of reports to one of our emergency wards, for example, are never viewed. Some areas do still receive paper reports but there is an inevitable delay before these are despatched and it is doubtful whether they are received/acted on within a clinically relevant timeframe. For those of you who are also using order comms, I would be grateful for your feedback and whether this parallels your experience. Kind regards Louise Tilbrook Louise Tilbrook Principal Clinical Scientist Dept of Clinical Biochemistry Mid Essex Hospitals NHS Trust Chelmsford CM1 7ET 01245 515036 07919 016847 ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. 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NHSmail is the secure email and directory service available for all NHS staff in England and Scotland NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSI recipients NHSmail provides an email address for your career in the NHS and can be accessed anywhere For more information and to find out how you can switch, visit www.connectingforhealth.nhs.uk/nhsmail ******************************************************************************************************************** ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. 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