Three days ago, I participated in a webinar sponsored by the Association for Pathology Informatics and Sunquest Information Systems. The overarching topic addressed for this (and later sessions) was the challenge for pathology informaticians of working in large multi-hospital health systems. The first of the two subtopics covered in this first session by Dr. Brian Jackson of ARUP Laboratories was the need for effective communication in hospitals beyond the EHR and LIS. He quoted a survey of primary care practitioners indicating that they rarely consulted with lab personnel about test ordering and test result interpretation. This experience may not necessarily translate to the experience of other specialists. However, I do believe that communications between the clinical labs and test-ordering physician and nurses could be improved.
I am sure that all labs in larger hospitals have some variant of a lab handbook or test directory posted for users. Here is the link to the publication of the University of Michigan hospital and here is the link to its lab test directory of ARUP. It's irrefutable that these directories are valuable resources for test-ordering clinicians. But let me restate the obvious. It may be difficult, on occasion, for a clinician to ferret out an informed answer about a particular test from such an online resource. In some cases, it would be far more efficient to call the labs and speak with the expert about a particular test. This problem becomes magnified in large multi-hospital health systems where the relevant expert may be located in a distant hospital and unknown to the calling physician. It would be helpful to develop an app such that a physician could click on a particular test in the on-line handbook and quickly be connected to the relevant lab expert for that test.
I don't know if such capabilities exist in web-based lab directories but I am sure that one criticism of such a system would be that it could be misused and distracting for lab personnel.This brings me to what I think is the key idea that I want to make in this note. In order to improve communication between lab professionals and clinicians, communication needs to be an important element of the job descriptions of lab personnel. They would thus be asked to demonstrate on a yearly basis that they are taking active measure to improve communications with test-ordering clinicians. I feel confident that with such a policy in place, the best communication channels would be developed.