LIMITATIONS OF PAPERLESS ONLINE REPORTING OF DIAGNOSTIC BACTERIOLOGY CULTURE RESULTS

Aims-To estimate the extent to which microbiology laboratory results m ade available on a computerised reporting system do not reach their in tended destination. Methods-Prospective observational study of 180 uri ne cultures submitted from patients seen at the accident and emergency department of a 250 bed university affiliated general hospital. Obser vations were made of: telephone requests for results; whether results were noted in patients' charts; and antibiotic administration to patie nts sent home. Results-Results were requested/recorded for 73% of 37 p atients admitted to hospital and for only 23% of 143 patients sent hom e (p < 1 x 10(-7)). Overall, results were more frequently recorded for patients with positive cultures (p = 0.04). When determined separatel y for admitted and discharged groups, this association was not shown. Three of 14 culture positive patients sent home and for whom results w ere not recorded received inappropriate therapy; 19 culture negative p atients were given antibiotics. Conclusions-in view of the results, me asures were instituted to ensure delivery of printed reports to the he alth care providers of patients not admitted from the accident and eme rgency department. Organisations operating computerised reporting syst ems in evolving health care settings must ensure that system design gu arantees delivery of reports to all end-users. This will minimise ther apeutic problems, reduce wastage of laboratory resources, and limit ri sks of litigation.