Improving follow-up of abnormal cancer screens using electronic health records: Trust but verify test result communication

An important, largely preventable but relatively unexplored reason for lack of follow-up is a problem in communication of the positive test result from the laboratory to the clinician who ordered it [14,15]. The use of electronic health records, especially those that utilize such features as automated communication of abnormal results from laboratories to clinicians, can potentially improve follow-up of abnormal cancer screens [1619]. Electronically "alerting" the ordering provider about an abnormal test result such as positive FOBT can improve the availability of vital information at the point of care [18]. As one of several multifaceted interventions to improve follow-up of positive FOBTs, our institution previously implemented standard operating procedures for the electronic health record’s test result communication system [19], including the transmission of a mandatory alert to the patient’s clinician for every positive FOBT result. This procedure was expected to reduce breakdowns in communication between the laboratory and clinicians.