Technologies for receiving test results in primary care practices and the impact of managed care

• Objective: To assess the availability and use of technologies that facilitate the receipt of diagnostic test results in primary care offices, physicians' perceptions of delays in receiving results, and the effect of managed care market penetration on these factors. • Design: Cross-sectional survey study. • Setting and participants: 2000 primary care physicians in 4 metropolitan areas with high managed care penetration and 4 areas with low penetration. • Measurements: A mailed survey measured the presence of technology in physician offices; methods for receiving results of laboratory tests, radiology studies, mammography, and Papanicolaou (Pap) tests; length of time to receive test results; how often physicians failed to receive results in a timely fashion; how often physicians had to repeat tests because of such failures; and how often these failures caused clinically significant delays in treatment. • Results: 41% of physicians received laboratory results electronically, and 16% received mammography and Pap test results electronically. Approximately two thirds of physicians reported that they did not receive laboratory test results and radiology studies in a timely fashion at least a little of the time. Nearly half did not receive mammography and Pap test results in a timely fashion at least a little of the time. Physicians perceived a clinically significant delay in treatment because of delays in reporting of laboratory (37%), radiology (35%), and mammography and Pap test (13%) results. Managed care penetration was not associated with receiving timely laboratory and radiology results or experiencing treatment delays. • Conclusion: Receipt of study results is problematic, regardless of the level of managed care penetration. Efforts should be directed at developing integrated systems that improve the tracking and receipt of study results at the practice level.

Duke Scholars

Author Eugene Zaverio Oddone Medicine, General Internal Medicine