Design and implementation of a comprehensive outpatient Results Manager.
Prior research has demonstrated that clinicians often fail to review and act upon outpatient test results in a timely and appropriate manner. To address this patient safety and quality of care issue, Partners Healthcare has developed a browser-based, provider-centric, comprehensive results management application to help clinic physicians review and act upon test results in a safe, reliable, and efficient manner. The application, called the Results Manager, incorporates extensive decision support features to classify the degree of abnormality for each result, presents guidelines to help clinicians manage abnormal results, allows clinicians to generate result letters to patients with predefined, context-sensitive templates and prompts physicians to set reminders for future testing. In this paper, we outline the design process and functionality of Results Manager. We also discuss its underlying architectural design, which revolves around a clinical event monitor and a rules engine, and the methodological challenges encountered in designing this application.
Poon
Eric G
EG
Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. epoon@partners.org
Wang
Samuel J
SJ
Gandhi
Tejal K
TK
Bates
David W
DW
Kuperman
Gilad J
GJ
D000553:Ambulatory Care / Q000379:methods*; D003628:Database Management Systems; D020000:Decision Support Systems, Clinical; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods*; D007721:Knowledge of Results, Psychological; D019300:Medical Errors / Q000517:prevention & control*; D016347:Medical Records Systems, Computerized; D010346:Patient Care Management / Q000379:methods*; D010865:Pilot Projects; D012984:Software; D012985:Software Design; D012986:Software Validation; D014584:User-Computer Interface