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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2020

Open Access 01-12-2020 | Research article

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

Authors: Louis Raymond, Éric Maillet, Marie-Claude Trudel, Josianne Marsan, Ana Ortiz de Guinea, Guy Paré

Published in: BMC Medical Informatics and Decision Making | Issue 1/2020

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Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.
Appendix
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Footnotes
2
A RHIEP is a multi-sided platform. On the one side, hospitals which usually include laboratories along with major CIS systems, join the platform and upload their patients’ data to the RHIEP’s database. On the other side, physicians query RHIEP’s database and download the available laboratory information.
 
3
The iEHR system deployed in Quebec, called the Quebec Health Record or QHR, is a secure provincial tool that is used to collect, store and release information about patients’ health. It is organized into 3 clinical domains: medications, laboratories and medical imaging. The health information contained in the QHR can be released on request to authorized providers and bodies in accordance with their access authorization. For more information: https://​www.​quebec.​ca/​en/​health/​your-health-information/​quebec-health-record/​.
 
4
VIFi = 1/(1-Ri2), where Ri2 is the unadjusted R2 obtained when componenti is regressed against all other components of the formative construct.
 
5
This is consistent with other studies on the use of EMR systems in primary clinics. The extent to which the EMR is used by family physicians positively and significantly influences their own perceptions in terms of performance benefits [e.g., 23].
 
6
It is worth mentioning that this result is consistent with other studies conducted in primary care clinics which found that the EMR’s functional coverage positively and significantly influences the extent of EMR use by family physicians [23].
 
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Metadata
Title
Advancing laboratory medicine in hospitals through health information exchange: a survey of specialist physicians in Canada
Authors
Louis Raymond
Éric Maillet
Marie-Claude Trudel
Josianne Marsan
Ana Ortiz de Guinea
Guy Paré
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2020
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-020-1061-z

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