EHR ‘Triggers’ Effective in Reducing Time to Diagnostic Evaluation of Cancer

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Researchers at Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center have developed electronic health record-based trigger algorithms that identify patients at risk for delays in diagnostic evaluation of colon and prostate cancer.

Seventy-two primary care providers at the two sites participated in a study of the algorithms and associated intervention steps. The study included querying the EHR for patients with abnormal findings and lack of associated follow-up actions, manual review of triggered records, and communication of this information to PCPs via secure e-mail and, if needed, phone calls to ensure message receipt.

“Our computerized triggers scanned huge amounts of patient data in the electronic health record and flagged individuals at risk for delays in follow-up of cancer-related abnormal clinical findings,” said Hardeep Singh, M.D., associate professor of medicine at Baylor and chief of health policy, quality & informatics program for the Center for Innovations in Quality, Effectiveness and Safety at the DeBakey Veterans Affairs Medical Center. “Missed or delayed diagnoses are among the most common patient safety concerns in outpatient settings, and measuring and reducing them are a high priority.”

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“Electronic trigger-based interventions seem to be effective in reducing time to diagnostic evaluation of colorectal and prostate cancer as well as improving the proportion of patients who receive follow-up,” concludes the study. “Similar interventions could improve timeliness of diagnosis of other serious conditions.”

The full results of the 15-month study can be found here in the Journal of Clinical Oncology.

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