Electronic tracking system can improve follow-up after an abnormal Pap test

Aug 20, 2010

Researchers from Boston University School of Medicine (BUSM) report that physicians who use an automated, electronic medical record (EMR) tracking system to follow-up on patients with an abnormal Pap test could increase the number of women who achieved diagnostic resolution and have women achieve resolution in less time than using traditional methods. These findings appear in the Journal of General Internal Medicine.

Screening for with a Pap test is only as successful as the follow-up rate for an abnormal result. If a patient has a Pap test, yet does not receive appropriate follow-up for an abnormal result, then the opportunity to prevent or treat pre-cancerous lesions or cervical cancer is missed and the Pap test is ineffective.

The advent of tracking systems provides great potential to address inadequate follow-up on a systemic level. "We developed a tracking system for our internal EMR, and evaluated this tracking system as an intervention to improve adequate follow-up of abnormal Pap tests," said lead author Elizabeth Dupuis, MD, from the Section of General Internal Medicine in the Department of Medicine, and the Women's Health Interdisciplinary Research Center at BUSM.

The BUSM researchers compared abnormal Pap test follow-up rates for the 24 months prior to implementing the tracking system with rates 12 months after its implementation. The evaluation monitored all subjects for 12 months from the date of their abnormal Pap test through diagnostic resolution. Controlling for type of abnormality and practice location, the adjusted time to resolution decreased significantly from 108 days prior to implementing the tracking system to 86 days after implementation.

"Although our study could not demonstrate that with this system we directly avoided cases of invasive cervical cancer, we did show that in an at-risk urban population, an automated, EMR-based tracking system reduced the time to resolution, and increased the
number of women who achieved diagnostic resolution," added Dupuis. "Most EMRs in use today do not have such tracking systems developed. Our data suggests that such systems can improve patient safety and patient care."

The researchers believe a combination of both systems and patient barriers impede adequate abnormal Pap test follow-up. Patient barriers include difficulty in keeping follow-up appointments, limited understanding of the significance of the abnormality and other life-issues taking priority. Systems barriers include failure of the provider to be aware of an abnormal result, and limited capability to systematically track patients who do not keep follow-up appointments. "Our program addressed the systems barriers by giving providers tools to allow them to more easily track subjects after an abnormal . Our higher baseline follow-up rates may already reflect some of the benefits of an EMR system; however, delays persisted without a ," said Dupuis.

Explore further: Cold cash just keeps washing in from ALS challenge

Provided by Boston University Medical Center

not rated yet
add to favorites email to friend print save as pdf

Related Stories

HPV vaccine reduces abnormal pap test results

Mar 10, 2008

In testing GARDASIL reduced abnormal Pap test results by 43 percent compared to women not given the vaccine, according new research. The findings show the approved anti-HPV agent appears to prevent the development of cell ...

Cervical cancer screening: Too many are left unprotected

Sep 19, 2007

The decline in cervical cancer is a success story of cancer research. Although there are reasons to be optimistic about even further decreases in cervical cancer incidence, there still remain some women who are not screened. ...

Recommended for you

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

Mind over matter for people with disabilities

Aug 26, 2014

People with serious physical disabilities are unable to do the everyday things that most of us take for granted despite having the will – and the brainpower – to do so. This is changing thanks to European ...

Ukraine's former world's tallest man dies

Aug 25, 2014

Ukraine's tallest man, who briefly held the world record but gave it up to live as a recluse, has died due to complications from the condition that saw him never stop growing, local media reported Monday.

User comments : 0