RESUMEN
PURPOSE: Few organizations have reported providing radiology reports to patients via an electronic health record patient portal. The authors describe the process of manual release of reports made by referring physicians, and patients' and referring physicians' experiences during the first year that release through the portal was available. METHODS: A survey of 508 patients assessed perceived accessibility and importance of portal-released radiology reports, and communications with referring physicians before and after the release. A survey of 48 referring physicians and a group interview assessed the utility of releasing reports, preferences regarding automatic release, and workload impact. Data were analyzed using descriptive statistics and qualitative methods. RESULTS: A total of 74% (377) of patients found reports easy to access, and 88% (446) reported that the ability to do so was important. In all, 49% (250) of patients were contacted by their referring physician before report release, and 25% (156) contacted their physician for more information after viewing a report. Of the referring physicians, 88% (42) found that releasing reports to patients was useful. Auto-release of x-ray reports, with a 1-week delay, was preferred by 58% (28), but they were more reluctant to auto-release CT and MRI reports. A total of 86% (41) of referring physicians reported that follow-up emails, telephone calls, and office visits were unchanged or had decreased. CONCLUSIONS: Referring-physician release of radiology reports via the online portal is important to patients, useful to referring physicians, and does not affect referring-physician workloads. A delay between reporting results to referring physicians and releasing them to patients allows time for needed physician-patient communication.
Asunto(s)
Acceso a la Información , Registros Electrónicos de Salud/estadística & datos numéricos , Derechos del Paciente , Sistemas de Información Radiológica/estadística & datos numéricos , Comunicación , Hawaii , Humanos , Entrevistas como Asunto , Satisfacción del Paciente , Relaciones Médico-Paciente , Derivación y Consulta , Encuestas y Cuestionarios , Carga de TrabajoRESUMEN
We examined the impact of implementing a comprehensive electronic health record (EHR) system on ambulatory care use in an integrated health care delivery system with more than 225,000 members. Between 2004 and 2007, the annual age/sex-adjusted total office visit rate decreased 26.2 percent, the adjusted primary care office visit rate decreased 25.3 percent, and the adjusted specialty care office visit rate decreased 21.5 percent. Scheduled telephone visits increased more than eightfold, and secure e-mail messaging, which began in late 2005, increased nearly sixfold by 2007. Introducing an EHR creates operational efficiencies by offering nontraditional, patient-centered ways of providing care.
Asunto(s)
Atención Ambulatoria/organización & administración , Prestación Integrada de Atención de Salud/organización & administración , Registros Electrónicos de Salud , Programas Controlados de Atención en Salud/organización & administración , Atención Ambulatoria/estadística & datos numéricos , Eficiencia Organizacional , Humanos , Sistemas de Información , Innovación Organizacional , Estudios RetrospectivosRESUMEN
The Advanced/Policy Track of the 2004 Kaiser Permanente Evidence-Based Medicine Symposium was an interactive session that focused on developing evidence-based clinical practice guidelines. The hypothetical scenario involved the imaginary drug "Memoryboost," a treatment for dementia. The participants were given materials describing the national Kaiser Permanente (KP) methodology for developing evidence-based guidelines and a summary of the highest-quality articles about the efficacy of this drug. The participants then formed small groups and used this information to develop a recommendation about its use for the treatment of dementia. In spite of having the same evidence, the groups developed three different recommendations. The entire group then explored some of the reasons for this variability. This article also addresses the reasons KP develops its own national guidelines, as well as who oversees the national guideline initiative and who develops guidelines.