Mucosal biopsies are often obtained during inpatient endoscopies to aid diagnosis.
Up to 75% of patients are reported to have pending test results at discharge. Incomplete
result communication to patients can lead to patient anxiety and poor outcomes. This
study aimed to evaluate the impact of a systemwide electronic medical record (EMR)
update on result communication.
The researchers retrospectively reviewed 100 inpatient endoscopies pending histopathology
results at discharge to see if finalized results were communicated to the patients
within 30 days. The same metric was studied after implementation of an EMR update
that automatically routed results to the supervising endoscopist, by reviewing another
100 inpatient endoscopies during which biopsies were obtained. Follow-up rate pre–
and post–EMR update was compared.
Prior to the update, 47/77 (61.0%) histopathology results were communicated to the
patients. Of the 30 nonreported cases, 17 showed nonspecific/chronic inflammation,
8 had no abnormal findings, 3 showed hyperplastic colon polyps, and 2 had colonic
tubular adenomas. Following the EMR update, 65/71 (91.5%) of pathology results were
communicated, demonstrating an increase of 30.5 percentage points in the rate of follow-up
(95% confidence interval [CI] = 17.7–43.0, p < 0.0001).
This study observed that 39.0% of inpatient endoscopic mucosal biopsy results in one
health care system were not communicated to the patients. Implementation of a systemwide
EMR intervention reduced this to 8.5% by shifting the responsibility of result communication
to the endoscopy team. Similar EMR enhancements can be applied to other pending test
results in health care systems with similar issues.