Advancing laboratory medicine in hospitals through health information exchange: a survey of specialist physicians in Canada

Abstract

Background: Laboratory testing occupies a prominent place in health care. Information technology systems have the potential to empower laboratory experts and to enhance the interpretation of test results in order to better support physicians in their quest for better and safer patient care. This study sought to develop a better understanding of which laboratory information exchange (LIE) systems and features specialist physicians are using in hospital settings to consult their patients' laboratory test results, and what benefit they derive from such use. Methods: As part of a broader research program on the use of health information exchange systems for laboratory medicine in Quebec, Canada, this study was designed as on online survey. Our sample is composed of 566 specialist physicians working in hospital settings, out of the 1512 physicians who responded to the survey (response rate of 17%). Respondents are representative of the targeted population of specialist physicians in terms of gender, age and hospital location.Results: We first observed that 80% of the surveyed physicians used the province-wide interoperable electronic health records (iEHR) system and 93% used a laboratory results viewer (LRV) to consult laboratory test results and most (72%) use both systems to retrieve lab results. Next, our findings reveal important differences in the capabilities available in each type of system and in the use of these capabilities. Third, there are differences in the nature of the perceived benefits obtained from the use of each of these two systems. Last, the extent of use of an LRV is strongly influenced by the IT artefact itself (i.e., the hospital's LRV available capabilities) while the use of the provincial iEHR system is influenced by its organizational context (i.e. the hospital's size and location). Conclusions:The main contribution of this study lies in its insights into the role played by context in shaping physicians' choices about which laboratory information exchange systems to adopt and which features to use, and the different perceptions they have about benefits arising from such use. One related implication for practice is that success of LIE initiatives should not be solely assessed with basic usage statistics.

Analysis of laboratory data transmission between two healthcare institutions using a widely used point-to-point health information exchange platform: a case report

“…Laboratory testing occupies a prominent place in healthcare. 20 While interoperability of laboratory data can improve patient care, 3 if it is not sufficiently complete, accurate, and comparable, then attempts at data exchange across institutions can result in potential patient safety issues. 21 …”

Transforming Health Data to Actionable Information: Recent Progress and Future Opportunities in Health Information Exchange

“…HIE has been shown to be a catalyst to encourage patients to be shared across multiple clinical sites; however, sharing of patient populations may lead to concerns of potential clinical competition between hospitals [54,88]. Functional HIE enables access to critical decision-driving data, such as laboratory findings and test results [89]. Acknowledging the breadth of hospital types and clinical catchment area demographics, studies have shown that the type of hospital can impact the quality of HIE [53,90].…”

Medical students’ intention to integrate digital health into their medical practice: A pre-peri COVID-19 survey study in Canada

“…Previous research has shown that dHealth has the potential to prevent disease 3,4 and lower healthcare costs, 5,6 while helping patients monitor and selfmanage chronic conditions 7,8 or optimizing the identification and use of available community resources by frail and isolated older adults. 9,10 It has also been shown that dHealth technologies can improve the quality, continuity, and availability of care, [11][12][13] tailor medical treatments for individual patients 14,15 and facilitate remote patient assessment and follow-up during pandemics. 16,17 For the practice of medicine to continue transforming itself and producing better outcomes for patients, future generations of physicians must be able to navigate with ease in an ever-changing digital environment.…”