Automated notification system cuts follow-up by 5 days, reduces 30-day readmissions by 8%

The implementation of an automated notification system improved tests pending at discharge (TPAD) follow-ups by five days and reduced 30-day readmissions by 8.3 percent, according to a study published March 12 in the Journal of General Internal Medicine.

Too often, patients are discharged from the hospital while tests are pending. These pending tests are then put aside, and patients often receive results. In some hospitals, the follow-up is as low as 20 percent. In response, researchers at Brigham and Women's Hospital implemented an automated notification system to improve TPAD follow-up.

"There is a communication gap between attending physicians based in the hospital and primary care doctors located elsewhere which can lead to important test results being missed," said corresponding author Anuj K. Dalal, MD, Hospitalist at BWH. "We found that implementing a simple automated notification system can help bridge this communication gap."

Researchers sampled 3,378 TPADs, 253 of which were found to be actionable by physician’s review. The notification system was then tested on 150 of these TPADs, while the remaining 103 were put into usual care groups. Results showed the automated notification system significantly shortened the time between documented action for TPADs, allowing patients to receive their follow-ups more quickly. Overall, the notification system improved actionable time by five days, proportion of documented action by 4.4 percent and reduced 30-day readmission by 8.3 percent.

However, the systems implementation still left 40 percent of patients without any documented follow-up. In the future, Dalal and colleagues hope to advance the notification system by incorporating it into patient electronic health records that notifies physicians of discharges and empowering patients in collecting their results.

"Just like you might get an automated notification, notifying you of the delivery of a package, we hope to implement such an automated system that notifies patients, primary care providers, and attending physicians when it is time to follow-up high-risk test results," said Dalal.