Skip to content Skip to navigation

Research: Electronic Triggers Reduce Delays in Cancer Diagnosis Evaluations

August 27, 2015
by Rajiv Leventhal
| Reprints

Electronic triggers designed to search for key data in electronic health records (EHRs) were able to identify and reduce follow-up delays for patients being evaluated for a diagnosis of colon or prostate cancer, according to researchers at Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center.

"Our computerized triggers scanned huge amounts of patient data in the electronic health record and flagged individuals at risk for delays in follow-up of cancer-related abnormal clinical findings," said Hardeep Singh, M.D., associate professor of medicine at Baylor and chief of health policy, quality & informatics program for the Center for Innovations in Quality, Effectiveness and Safety at the DeBakey Veterans Affairs Medical Center. "We created these trigger algorithms in the hopes of being able to leverage electronic health records to improve patient care and safety."

The investigators' analysis defined timely follow-up as 30 days for suspected lung cancer, 60 days for colon cancer and 90 days for prostate cancer. Many factors, including primary care workloads, time pressures and information overload, and lack of robust test result tracking systems can contribute to delays in evaluating patients whose original findings were suggestive of cancer, Singh said.

Singh and participating researchers recruited 72 primary care clinicians at two study sites for this 15-month study and divided providers into intervention and control groups. In the control group, clinicians followed up suspicious findings through usual procedures whereas in the intervention group, the study team applied triggers twice a month to all patients under their care. Triggers consider the following test results as red flags if the patient did not receive timely follow-up: positive fecal occult blood test; iron deficiency anemia; elevated prostate specific antigen; and abnormal imaging suspicious for cancer.

"There are few, if any, human- or technology-based solutions that efficiently identify such care delays," said Dr. Daniel Murphy, first author on the paper and instructor in the department of medicine and health services researcher at Baylor and the DeBakey Veterans Affairs Medical Center. "Triggers can act as safeguards as long as the information about potential delays can be communicated to clinicians taking care of these patients."

"While all patients flagged by the computerized trigger algorithm in the intervention group are considered at risk, we confirmed the presence of delay by manually reviewing their records and communicating to their clinicians only when necessary," Singh said. Singh and his team are refining and exploring trigger application in other settings to detect and monitor delays and improve timeliness of cancer diagnoses.



Texas Patient Care Clinic Hit with Ransomware Attack

Grand Prairie, Texas-based Rainbow Children's Clinic was the victim of a ransomware attack on its IT systems in August, affecting more than 33,000 patients, according to multiple news media reports this week.

Healthcare Organizations Again Go to Bat for AHRQ

Healthcare organizations are once again urging U.S. Senate and House leaders to protect the Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) from more budget cuts for 2017.

ONC Pilot Projects Focus on Using, Sharing Patient-Generated Health Data

Accenture Federal Services (AFS) has announced two pilot demonstrations with the Office of the National Coordinator for Health Information Technology (ONC) to determine how patient-generated health data can be used by care teams and researchers.

Is it Unethical to Identify Patients as “Frequent Flyers” in Health IT Systems?

Several researchers from the University of Pennsylvania addressed the ethics of behavioral health IT as it relates to “frequent flyer” icons and the potential for implicit bias in an article published in JAMA.

St. Joseph Health to Pay $2.14M in HIPAA Settlement

St. Joseph Health (SJH) has agreed to settle potential violations of the HIPAA privacy and security rules following reports that files containing sensitive health data were publicly accessible through Internet search engines from 2011 to 2012.

Indian Health Service and Children's Hospital of Philadelphia Partner on Pediatric Telehealth

The Department of Pediatrics at the Children's Hospital of Philadelphia (CHOP) plans to partner with the Indian Health Service (IHS) to create a pediatric specialty consultation service using telehealth for American Indian and Alaska Native children served by IHS.