Advancing laboratory medicine in hospitals through health information exchange: a survey of specialist physicians in Canada

• Published in: BMC medical informatics and decision making Vol. 20; no. 1; p. 44
• Main Authors: Raymond, Louis, Maillet, Éric, Trudel, Marie-Claude, Marsan, Josianne, de Guinea, Ana Ortiz, Paré, Guy
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 28.02.2020; BioMed Central; BMC
• Subjects: Clinical Laboratory Techniques; Electronic health records; Electronic records; Female; Health care information services; Health facilities; Health informatics; Health Information Exchange - standards; Health Information Exchange - statistics & numerical data; Hospital; Hospital laboratories; Hospitals; Humans; Information systems; Information technology; Internet; Laboratory information exchange; Laboratory medicine; Laboratory tests; Male; Management; Medical consultation; Medical laboratories; Medical records; Medical research; Medicine; Middle Aged; Nature; Patient care; Patients; Perceived benefits; Physicians; Physicians - psychology; Physicians - statistics & numerical data; Polls & surveys; Quebec; Retirement benefits; Setting (Literature); Specialist physician; Specialization; Surveys and Questionnaires; Technology; Quebec; Canada; Quebec Canada; Perceived benefits; Laboratory information exchange; Laboratory medicine; Online survey research; Hospital; Specialist physician; Information systems
• ISSN: 1472-6947; 1472-6947
• DOI: 10.1186/s12911-020-1061-z

Laboratory testing occupies a prominent place in health care. Information technology systems have the potential to empower laboratory experts and to enhance the interpretation of test results in order to better support physicians in their quest for better and safer patient care. This study sought to develop a better understanding of which laboratory information exchange (LIE) systems and features specialist physicians are using in hospital settings to consult their patients' laboratory test results, and what benefit they derive from such use. As part of a broader research program on the use of health information exchange systems for laboratory medicine in Quebec, Canada, this study was designed as on online survey. Our sample is composed of 566 specialist physicians working in hospital settings, out of the 1512 physicians who responded to the survey (response rate of 17%). Respondents are representative of the targeted population of specialist physicians in terms of gender, age and hospital location. We first observed that 80% of the surveyed physicians used the province-wide interoperable electronic health records (iEHR) system and 93% used a laboratory results viewer (LRV) to consult laboratory test results and most (72%) use both systems to retrieve lab results. Next, our findings reveal important differences in the capabilities available in each type of system and in the use of these capabilities. Third, there are differences in the nature of the perceived benefits obtained from the use of each of these two systems. Last, the extent of use of an LRV is strongly influenced by the IT artefact itself (i.e., the hospital's LRV available capabilities) while the use of the provincial iEHR system is influenced by its organizational context (i.e. the hospital's size and location). The main contribution of this study lies in its insights into the role played by context in shaping physicians' choices about which laboratory information exchange systems to adopt and which features to use, and the different perceptions they have about benefits arising from such use. One related implication for practice is that success of LIE initiatives should not be solely assessed with basic usage statistics.