One of the key areas of laboratory to physician communication is that of reporting critical values. Since regulators and accreditation organizations define critical values as abnormal test results that are potentially life threatening and require a rapid response from caregivers, any steps taken to improve this process impacts the quality of patient care. This not only refers to the timeliness of reporting test results, but ensuring that these results reach the intended physicians no matter where they are and that the information sent and received is secure.
Thanks to the rapid spread of mobile technology, including mobile phones, pagers, tablets, and computers linked to electronic health records, new more secure messaging systems to report critical values are available. Another new application of mobile technology is in real-time patient monitoring using wearables, such as watches and wristbands synced to mobile phones. In these cases, if critical values are detected, it can be immediately transmitted to the laboratory’s electronic health records system (EHR), and the physician notified immediately.
However, along with these advances have come issues of information overload which can act as a counter-force to the progress that these devices provide. In the same way that laboratories often feel frustrated when they are not able to reach physicians to release critical results, physicians increasingly feel overwhelmed with the high volume of alerts, calls, and other messages that they are receiving. As a result, even with the increasing number of high-tech tools available, labs often struggle to optimize critical value reporting. Realistically, this cannot be solved unilaterally by the laboratory. There must be active ongoing collaboration with physicians to identify problem areas, and seek solutions through mutually agreed upon strategies. The problem with information overload is how to distinguish laboratory alerts from all the other alerts that are coming in as well. This collaboration should produce uniform policies applicable to all physicians on staff, not customized for individual physicians.