2005 OPEN FORUM Abstracts
PULMONARY FUNCTION TESTING INTERPRETATION AND REPORT GENERATION IS A SLOW, CUMBERSOME, AND INEFFICIENT PROCESS.
Davies J, Crapo R, and MacIntyre NR for the American Thoracic Society Pulmonary Function Laboratory Registry.
Background: A great deal of effort over the last 15 years has been expended in pulmonary function testing (PFT) technical standardization and test quality improvement by numerous professional organizations (ATS-ERS Pulmonary Function Laboratory Standards. Eur Resp J. 2005;26: in press). In contrast, the process of test interpretation, report generation, and distribution to clinicians and record repositories has received very little attention. This is unfortunate as these processes can be quite time consuming, prone to numerous errors and may often involve redundant functions (e.g. a physician may dictate a report and then have to verify the accuracy of the transcription at a subsequent time).
Methods: To explore the scope of these problems, the American Thoracic Pulmonary Function Laboratory Registry conducted a survey among 35 of its members exploring issues involved in the test interpretation-report generation process. 79% of the responding labs were hospital based with large test volumes (average of 1983 spirometries and 1241 DLCOs per year).
Results: Among the more salient responses:
- 89% of the labs generate paper reports for physicians to interpret
- 40% of these reports include all previous tests, 34% include only the most recent
- 31% provide a "pre-read" by a computerized algorithm
- 67% of the tests require a transcriptionist (and thus a subsequent verification
by the physician interpreter), 15% of the tests have physician interpreters hand-write the interpretation on the final report, 12% of the tests have the physician interpreter type onto the computer report.
- 46% provide raw test data to ordering physicians immediately (before interpretation)
- Average turnaround time: < 1 day (15%) 1- 2 days (30%), 3-4 days (27%), 5-6 days (15%), > 7 days (3%)
- Understanding of billing/coding rules: good understanding (38%), adequate understanding (49%), poor understanding (12%)
Conclusion: These data suggest that the PFT interpretation and report generation process is slow, cumbersome and often involves redundant steps. These features make the process both expensive and prone to errors. Opportunities exist for manufacturers to help labs streamline these processes.