Kaiser Permanente to add EHR alerts for follow-up tests after abnormal lab results

Adding a flag to the EHR to notify physicians when a patient has an abnormal test result for chronic kidney disease may help improve patients' follow-up care, according to a recent Oakland, Calif.-based Kaiser Permanente study.

For the study, which was published in the American Journal of Kidney Diseases, Kaiser Permanente researchers analyzed EHR data of 244,540 patients with incident abnormal estimated glomerular filtration rate for the diagnosis of chronic kidney disease. The lab results were from January 2010 to December 2015 and help determine whether the patient's kidneys are working as well as they should.

Results of the study showed that 58 percent of patients with a newly abnormal eGFR did not receive timely follow-up testing following the abnormal result. An abnormal creatinine result flag in the EHR was associated with enhanced follow-up, with a 95 percent confidence interval. The research team also conducted interviews with 15 physicians, which revealed system-level, such as assistance with managing lab results, and provider-level, including ability to use EHR tools, factors that impacted lab result management.

Due to the study, Kaiser Permanente will be integrating a flag within its EHR system for abnormal eGFR lab test results as well as collaborate with physicians to create systems that can help enhance workflow, said Kim N. Danforth, lead study investigator and a member of Kaiser Permanente Southern California's research and evaluation department, according to a news release.

The study authors concluded that while care gaps in the follow-up of abnormal eGFR results are common, more research needs to be done to determine whether initiatives such as implementing EHR alerts for follow-up testing will help improve care long term.

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