Impact of an Electronic Health Record on Follow-up Time for Markedly Elevated Serum Potassium Results

Abstract

Follow-up of abnormal ambulatory laboratory results is often suboptimal. The impact of an ambulatory electronic health record (EHR) on follow-up of markedly elevated blood potassium (K( +)) results was investigated via a retrospective medical record review-before and after EHR implementation-of patients at an adult primary care practice who had a nonhemolyzed K(+) ≥ 6.0 mEq/L. In all, 188 patients in the pre-EHR group and 30 in the EHR group satisfied inclusion criteria. The mean K(+) for the 2 groups was 6.3 mEq/L. The EHR group had 4.5 times the odds (95% confidence interval = 1.3-15.8) of having their episodes of hyperkalemia followed up within 4 days. Patients in the EHR group were also more likely to have their blood K(+) rechecked within 4 days (63.3% vs 43.6%; P = .044). An ambulatory EHR with a results management system improves documentation and time to follow-up for patients with markedly abnormal lab results.