Part of the appeal of electronic medical records is that they can help doctors keep track of test results and avoid medical errors, but a study released on Monday suggests that doctors sometimes ignore electronic warnings about abnormal test results.
Researchers found doctors failed to follow up on nearly 8 percent of electronic alerts that a patient had something abnormal on an X-ray, mammogram, computed tomography or CT or magnetic resonance imaging or MRI scan that needed quick attention.
Just the fact that you can use technology to deliver a piece of information from the radiologist to a doctor doesn't mean it will be taken care of, said Dr. Hardeep Singh of the Baylor College of Medicine in Houston, whose study appears in the Archives of Internal Medicine.
The electronic health record system is a huge improvement from previous paper-based systems, but it is not perfect, Singh said in a telephone interview.
President Barack Obama has made electronic medical records a centerpiece of his health reform efforts, promising nearly $1.2 billion to help doctors and hospitals make the switch from paper-based records.
The systems not only allow doctors to share a patient's medical record, but they also can advise on proven treatments, and send reminders on test results.
Singh said many Veterans Affairs medical centers have been using them for nearly a decade. He and colleagues looked to see how well the alerts were working to ensure doctors took action on test results.
They studied alert notifications from an outpatient imaging center at one VA hospital between November 2007 and June 2008.
Out of 123,638 tests, 1,200 generated alerts to the doctors who had ordered the tests that a patient had abnormal results and needed timely follow-up.
Of these, in 7.7 percent of cases, patients did not get timely follow up, and in nearly all of these cases, this time lag resulted in patients' conditions getting worse.
Singh said even with the best of information systems, patients with abnormal imaging results are vulnerable to falling through the cracks. The problem may be the result of information overload, he said.
Singh said the findings suggest that while helpful, electronic medical records do not eliminate the problem of missed test results, and other strategies need to be used to ensure patients get prompt care -- perhaps rules that clear up any ambiguity over who is responsible for following up.