While clinicians have long assumed the responsibility of managing patient test results, increased patient volume with heightened emphasis on chronic disease management and the proliferation of ever-changing clinical guidelines have turned this responsibility into a serious challenge. A survey performed within our healthcare network indicates that clinicians are not satisfied with their current system of result tracking, and that automated result tracking and patient-letter writing capabilities represent the two most pressing needs of our clinicians.

We are developing a browser-based, provider-centric, comprehensive results manager to help clinic physicians review and act upon test results in a timely and efficient manner. Results Manager will present all results to the ordering clinician, with critical results flagged appropriately. Results will be displayed in the context of previous results, along with the patients’ medication and problem list. The system will allow clinicians to acknowledge and act on test results, and have their actions documented electronically. Tools will be provided to allow the user to write patient result letters, and the system will also provide clinical decision support to improve compliance with national guidelines on the follow-up of abnormal results, such as abnormal mammograms and Pap smears.

The underlying architectural design of Results Manager revolves around a real-time clinical event monitor and rules engine that processes all test results filed into the CDR. Clinical decision support rules will determine the recommendations for follow-up action and result interpretation for inclusion in the patient result letter.

Challenges of this project include the need to support diverse workflow patterns of clinics belonging to different specialties, and the need to integrate results from a large number of legacy results reporting systems. We expect that the Results Manager system will enhance both workflow and patient safety.