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Physicians May Fail to Act on Electronic Alerts Quickly

Within two weeks, 18.1 percent of alerts for images in VA system were unacknowledged

THURSDAY, Oct. 1 (HealthDay News) -- Physicians using a system with electronic medical records and computerized alerts may not acknowledge or act upon critical imaging results in a timely manner, according to research published in the Sept. 28 Archives of Internal Medicine.

Hardeep Singh, M.D., of the VA Medical Center in Houston, and colleagues analyzed data from 123,638 outpatient studies -- including radiographs, computed tomography scans, and MRIs -- from which 1,196 images generated alerts that were electronically transmitted in a Veterans Affairs ambulatory clinic and satellite clinics.

The researchers found that 217 (18.1 percent) of these alerts were unacknowledged, meaning that the health care provider (HCP) didn't open the message for viewing within two weeks. Alerts were more likely to be unacknowledged when the ordering HCP was a trainee (odds ratio, 5.58) and when the alert was sent to more than one HCP (odds ratio, 2.02). The authors further note that 7.7 percent of the alerts did not have timely follow-up at four weeks, with a similar rate for acknowledged and unacknowledged alerts.

"We propose several potential interventions based on our findings that can be used immediately to improve timely follow-up of abnormal imaging results. First, every institution must develop and publicize a policy regarding who is responsible (primary care provider versus the ordering HCP, who may be a consultant) for taking action on abnormal results. Second, unacknowledged alerts should require the HCP's signature and statement of action before they are allowed to drop off from the screen," Singh and colleagues conclude.

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