Physician survey of a laboratory medicine interpretive service and evaluation of the influence of interpretations on laboratory test ordering

Arch Pathol Lab Med. 2004 Dec;128(12):1424-7. doi: 10.5858/2004-128-1424-PSOALM.

Abstract

Context: Complex coagulation test panels ordered by clinicians are typically reported to clinicians without a patient-specific interpretive paragraph.

Objectives: To survey clinicians regarding pathologist-generated interpretations of complex laboratory testing panels and to assess the ability of the interpretations to educate test orderers.

Design: Surveys were conducted of physicians ordering complex coagulation laboratory testing that included narrative interpretation. Evaluation of order requisitions was performed to assess the interpretation's influence on ordering practices.

Setting: Physicians ordering coagulation testing at a large academic medical center hospital in Boston, Mass, and physicians from outside hospitals using the academic medical center as a reference laboratory for coagulation testing.

Outcome measures: Physician surveys and evaluation of laboratory requisition slips.

Results: In nearly 80% of responses, the ordering clinicians perceived that the interpretive comments saved them time and improved the diagnostic process. Moreover, the interpretations were perceived by ordering clinicians to help prevent a misdiagnosis or otherwise impact the differential diagnosis in approximately 70% of responses. In addition, interpretations appeared to be able to train the ordering clinicians as to the standard ordering practices.

Conclusions: The results demonstrate physician satisfaction with an innovative information delivery approach that provides laboratory diagnostic interpretation and test-ordering education to clinicians in the context of their daily workflow.

Publication types

  • Evaluation Study

MeSH terms

  • Academic Medical Centers / trends
  • Blood Coagulation Tests / methods*
  • Blood Coagulation Tests / trends*
  • Boston
  • Data Collection / statistics & numerical data
  • Diagnostic Services / trends*
  • Diagnostic Tests, Routine / methods*
  • Diagnostic Tests, Routine / trends*
  • Humans
  • Physicians / statistics & numerical data*
  • Reference Values
  • Surveys and Questionnaires