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Despite More Tests, Some Aren't Getting Results

Electronic record-keeping alone isn't the answer, researcher says

By Jennifer Thomas
HealthDay Reporter


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MONDAY, July 6 (HealthDay News) -- More than half of the time, test results revealing abnormalities in the aorta were not included in patients' electronic medical records within three months, new research has found.

Nearly a third of the time, still no record was found three years later.

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The findings add to a growing body of research that is raising concerns about communication breakdowns between specialists, emergency room doctors, primary care doctors, nurses and their patients when sharing the results of diagnostic tests.

"We are using more and more diagnostic testing in medicine these days, those tests all have to be followed up on, and we don't currently have systems to do that," said study author Dr. Peter Cram, an associate professor of internal medicine at the University of Iowa Carver College of Medicine. "It used to be you'd spend a half-hour with your doctor and they'd order one test. Now they spend 15 minutes with you and order 30 tests."

The researchers examined medical data on 4,112 people who had computed tomography (CT) scans at the Veterans Affairs hospitals in Iowa City, Iowa, and Omaha, Neb.

About 11 percent, or 440 people, were found to have aortic dilations, or an area of the aorta that was weakened or bulging. The aorta, which runs from the heart through the chest and abdomen, is the main blood supply for the body.

Of those, 91 had new dilations that had not been previously noted in the medical record. Study participants had undergone the CT scans because of abdominal pain or kidney stones. The aortic abnormalities were found incidentally.

In 5 percent of the cases, radiologists notified clinical teams of the test results.

But in 58 percent of the new dilations, there was still no record of the dilation in the person's electronic medical record within three months of the CT scan. In 29 percent of the cases, there was no documentation of the aortic dilations after an average of three years.

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Copyright © 2009 ScoutNews, LLC. All rights reserved.
Last updated 7/6/2009

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SOURCES: Peter Cram, M.D., M.B.A., associate professor, internal medicine, Carver College of Medicine, University of Iowa, and health services researcher, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa; Andy Whittemore, M.D., chief medical officer, Brigham and Women's Hospital, Boston; July 6, 2009, Annals of Internal Medicine


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