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Implementation of automated reporting of estimated glomerular filtration rate among Veterans Affairs laboratories: a retrospective study.

dc.contributor.author Hall, RK
dc.contributor.author Hammill, Bradley Gordon
dc.contributor.author Jackson, GL
dc.contributor.author Maciejewski, Matthew Leonard
dc.contributor.author Patel, Uptal Dinesh
dc.contributor.author Svetkey, LP
dc.contributor.author Wang, V
dc.contributor.author Yano, EM
dc.coverage.spatial England
dc.date.accessioned 2015-08-19T02:50:00Z
dc.date.issued 2012-07-12
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/22788730
dc.identifier 1472-6947-12-69
dc.identifier.uri http://hdl.handle.net/10161/10411
dc.description.abstract BACKGROUND: Automated reporting of estimated glomerular filtration rate (eGFR) is a recent advance in laboratory information technology (IT) that generates a measure of kidney function with chemistry laboratory results to aid early detection of chronic kidney disease (CKD). Because accurate diagnosis of CKD is critical to optimal medical decision-making, several clinical practice guidelines have recommended the use of automated eGFR reporting. Since its introduction, automated eGFR reporting has not been uniformly implemented by U. S. laboratories despite the growing prevalence of CKD. CKD is highly prevalent within the Veterans Health Administration (VHA), and implementation of automated eGFR reporting within this integrated healthcare system has the potential to improve care. In July 2004, the VHA adopted automated eGFR reporting through a system-wide mandate for software implementation by individual VHA laboratories. This study examines the timing of software implementation by individual VHA laboratories and factors associated with implementation. METHODS: We performed a retrospective observational study of laboratories in VHA facilities from July 2004 to September 2009. Using laboratory data, we identified the status of implementation of automated eGFR reporting for each facility and the time to actual implementation from the date the VHA adopted its policy for automated eGFR reporting. Using survey and administrative data, we assessed facility organizational characteristics associated with implementation of automated eGFR reporting via bivariate analyses. RESULTS: Of 104 VHA laboratories, 88% implemented automated eGFR reporting in existing laboratory IT systems by the end of the study period. Time to initial implementation ranged from 0.2 to 4.0 years with a median of 1.8 years. All VHA facilities with on-site dialysis units implemented the eGFR software (52%, p<0.001). Other organizational characteristics were not statistically significant. CONCLUSIONS: The VHA did not have uniform implementation of automated eGFR reporting across its facilities. Facility-level organizational characteristics were not associated with implementation, and this suggests that decisions for implementation of this software are not related to facility-level quality improvement measures. Additional studies on implementation of laboratory IT, such as automated eGFR reporting, could identify factors that are related to more timely implementation and lead to better healthcare delivery.
dc.language eng
dc.relation.ispartof BMC Med Inform Decis Mak
dc.relation.isversionof 10.1186/1472-6947-12-69
dc.subject Health Plan Implementation
dc.subject Humans
dc.subject Kidney
dc.subject Medical Records Systems, Computerized
dc.subject Practice Guidelines as Topic
dc.subject Practice Patterns, Physicians'
dc.subject Renal Insufficiency, Chronic
dc.subject Retrospective Studies
dc.subject Risk Assessment
dc.subject Time Factors
dc.subject United States
dc.subject United States Department of Veterans Affairs
dc.title Implementation of automated reporting of estimated glomerular filtration rate among Veterans Affairs laboratories: a retrospective study.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/22788730
pubs.begin-page 69
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Duke Clinical Research Institute
pubs.organisational-group Global Health Institute
pubs.organisational-group Institutes and Centers
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group Medicine
pubs.organisational-group Medicine, General Internal Medicine
pubs.organisational-group Medicine, Nephrology
pubs.organisational-group Pediatrics
pubs.organisational-group Pediatrics, Nephrology
pubs.organisational-group School of Medicine
pubs.organisational-group University Institutes and Centers
pubs.publication-status Published online
pubs.volume 12
dc.identifier.eissn 1472-6947


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