Doctors up in arms over lab report fatigue

The sudden deluge of partial lab reports in EMR inboxes following LifeLabs’ transition to a new report distribution system earlier this summer has Ontario doctors up in arms. Partial lab reports that clog EMR inboxes are not a new irritant, but prior to the introduction of the new system doctors could call LifeLabs and opt for final reports only. That’s not an option anymore.There is no solution to this issue currently, but the number of partial reports doctors are receiving can be reduced by EMR vendors decreasing the frequency that their systems “poll through LifeLabs’ proprietary feed for lab results,” advised Katherine Tudor, OntarioMD’s director of marketing and communications. “If your EMR polls every few minutes or every hour, you can ask your EMR vendor to poll the feed as often as is suitable for you.”Dr. Adam Stewart, a family doctor based in Madoc, Ont., raised the issue in a LinkedIn post, asking, “Anyone else frustrated by this? As if family doctors didn’t already have enough avoidable admin burden. It’s terrible. We are now getting multiple notifications on the same lab reports. This seems to be because they push results to us when only some are done, but some are pending.“This is a patient safety issue,” he complained. “We doctors are going to get lab report fatigue. Not realizing which of the 10 lab results is new and important versus which ones we’ve already seen.”Read: New roster reconciliation tool available in OntarioDr. Stewart cited as an example a partial lab report indicating an abnormal sodium result that he would need to address but can’t because a TSH blood test result for thyroid performance is still pending.“If you’re a type A person like me, it’s going to cause me extra work because I have to send myself a note (reminding me) to act on this when the thyroid results come in and I know the complete picture. It’s extra work that we don’t need to be doing.”Confirming that the “conversion of physician report distribution to the new system is occurring only in Ontario,” an email from LifeLabs to the Medical Post stated: “Our goal is to make the transition is as smooth as possible. We are committed to working with healthcare practitioners to ensure their concerns are addressed and their experience with the new system is a positive one and meets their clinical needs.“We take physician feedback very seriously. To address physician concerns about receiving too many reports, LifeLabs has met with EMR providers to request they adjust their pull times to reflect physician requirements. Since the adjustment has been made, we have seen a notable improvement in the physician experience. For those physicians who would like a further reduction in partial reports, LifeLabs can request the EMR vendor (to) further adjust their pull times.”The company added that it’s “investigating making additional changes to the system to address physician preferences of only sending final reports.”LifeLabs, which was sold to U.S.-based Quest Diagnostics for C$1.3 billion in August, noted that “it shared several timely communications with all clients on the legacy platform to provide updates on the project, along with a dedicated email address and phone number for healthcare practitioners to contact us with any questions or concerns related to the conversion to the new system.”Doctors are also complaining about the inclusion of extraneous data identifying the time and date of every test “and who processed the tube” in the lab reports they’re receiving “instead of just being able to clearly see the lab values. Could these be appended as metadata instead in future?” asked Dr. Alexander Serbanescu on LinkedIn.“The bigger issue though is that there’s a lack of front-line family doctors having true influence at the decision-making tables,” complained Dr. Stewart. “This (conversion) should have been piloted, and feedback should have been sought from family doctors well before it was rolled out. There are countless examples of decisions being made regarding technology where local hospitals make a decision to implement a new system that all of a sudden affects the way family doctors are receiving reports.”Dr. Stewart, who uses the Telus PS Suite EMR, challenged the claim that some doctors prefer getting partial reports. “Generally speaking, doctors don’t want to receive partial reports,” he said. “In the rare instances when there’s something I want to check urgently, I could pull it manually.“My hope is that if enough of us start calling and emailing (LifeLabs) to let them know what a big issue this is, something will be done to address this issue.”

Doctors up in arms over lab report fatigue

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