Pediatric Informatics: Computer Applications in Child Health (Health ...

276 K.B. Johnson and C.G.M. Weigle
19.7.3.2 Results Reporting
Some ACPOE system interfaces have adapted the metaphor of an “inbox” for
results (Fig. 19.5). In clinic workflow, test results and prescription requests may
be initially screened by a nurse (who handles the bulk of routine tasks according
to office protocols), passing specific results (panic values, abnormals, etc.) and
requests (new prescriptions without an appointment) to the appropriate practice
physician. At any stage, a change in availability of one person might dictate a
rerouting of the result, and an especially important result might warrant the use of a
system of escalation to ensure timely communication with the patient or guardian.
The electronic inbox offers opportunities for added functionality not possible in
the paper-based system. For example, certain results may be broadcast to several
providers (such as a primary care provider and a specialist) for review or discussion
or for team coverage, where the result is requires only one team member to
respond to or acknowledge the result. Another example is a result that is part of a
series of results that form a trend, in which case a result would be linked to other
results as an embellishment on the original result or as an additional message to a
different provider altogether. Some sophistication of result transmission is required
when inpatient and outpatient care is recorded in the same electronic health record,
so that, for example, the hourly blood gas test results for a current ICU patient do
not overwhelm the in-box for her cardiologist in the clinic.
Fig. 19.5 An example of an ambulatory ACPOE Inbox for test results