Physician survey of a laboratory medicine interpretive service and evaluation of the influence of interpretations on laboratory test ordering.
BACKGROUND
Complex coagulation test panels ordered by clinicians are typically reported to clinicians without a patient-specific interpretive paragraph.


OBJECTIVE
To survey clinicians regarding pathologist-generated interpretations of complex laboratory testing panels and to assess the ability of the interpretations to educate test orderers.


METHODS
Surveys were conducted of physicians ordering complex coagulation laboratory testing that included narrative interpretation. Evaluation of order requisitions was performed to assess the interpretation's influence on ordering practices.


METHODS
Physicians ordering coagulation testing at a large academic medical center hospital in Boston, Mass, and physicians from outside hospitals using the academic medical center as a reference laboratory for coagulation testing.


METHODS
Physician surveys and evaluation of laboratory requisition slips.


RESULTS
In nearly 80% of responses, the ordering clinicians perceived that the interpretive comments saved them time and improved the diagnostic process. Moreover, the interpretations were perceived by ordering clinicians to help prevent a misdiagnosis or otherwise impact the differential diagnosis in approximately 70% of responses. In addition, interpretations appeared to be able to train the ordering clinicians as to the standard ordering practices.


CONCLUSIONS
The results demonstrate physician satisfaction with an innovative information delivery approach that provides laboratory diagnostic interpretation and test-ordering education to clinicians in the context of their daily workflow.
Laposata
Martha E
ME
Massachusetts General Hospital, Boston, MA 02114, USA. mlaposata@partners.org
Laposata
Michael
M
Van Cott
Elizabeth M
EM
Buchner
Dion S
DS
Kashalo
Mohammed S
MS
Dighe
Anand S
AS
D000046:Academic Medical Centers / Q000639:trends; D001780:Blood Coagulation Tests / Q000379:methods* / Q000639:trends*; D001900:Boston; D003625:Data Collection / Q000706:statistics & numerical data; D003954:Diagnostic Services / Q000639:trends*; D003955:Diagnostic Tests, Routine / Q000379:methods* / Q000639:trends*; D006801:Humans; D010820:Physicians / Q000706:statistics & numerical data*; D012016:Reference Values; D011795:Surveys and Questionnaires