Alerts to other physicians

Activation of the "expand action" facility does an efficient job of making referring physicians aware of missed reports, the authors said. This facility has proved particularly useful in the case of referring physicians who work part-time, who are retired, or who are on a lengthy vacation. It has also helped when referring physicians were not familiar with the operation of the alert system (e.g., when they only worked at the hospital for a short time).

The alert system can help avoid neglected reports of unexpected significant findings, and it is designed to make information more easily shared, they added. Separate qualitative audits may be useful to evaluate whether the practice is affected by the shared information. At Ofuna Chuo Hospital, currently staff check the contents of the medical record manually, but from now on the automation of qualitative audits and evaluation is under consideration.

"In Japan, it is important to communicate information within the EHR," Aoki and colleagues stated. "Overall clinical care from diagnosis to treatment is completed within one hospital, and the EHR is a common language in the Japanese medical environment."

Appropriate communication is an essential way of ensuring medical safety, and tools like alert systems contribute to good communication, they concluded. Follow-up of noncritical actionable findings is being examined by the Integrating the Healthcare Enterprise (IHE), raising hopes that greater standardization will occur.