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H. R. Garner, P. Latkany, A. Della Rocca, R. C. Della Rocca, H. M. Paek, J. Goulet; Perspective Regarding the Frequency of Repeat Diagnostic Testing Secondary to Poor Communication. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4992.
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: We hypothesize that ophthalmologists often have to add further instruction for technicians when ordering tests to work-up various ocular disease processes. When the added instruction is not given, tests often are not sensitive for the suspected disease and must be repeated. This repetition wastes both time and money.
In this study, an electronic survey was completed by attending and resident ophthalmologists inquiring about the process of diagnostic test ordering. The resulting data was analyzed to determine whether specific diseases warrant further methods of communication.
Out of 67 ophthalmologists, 66 in total completed the survey. Of these, 55 were attendings and 11 were residents. 75.9% of attending physicians were fellowship trained and 50% were currently working in a private practice setting. 87% of the physicians had ancillary staff at the facility where they worked, performing various ophthalmologic tests. 79.6% of the physicians needed to communicate further details regarding how to administer the test when working with a technician they had not worked with before. 85.2% have had to repeat a certain test because even though the test was performed correctly, it did not capture what the physician was looking for. 50% felt there was a particular test that needed specific communication to obtain the assay in the desired way, 25% of this group specifying visual field testing while only 2% said obtaining corneal cultures. According to the z-test for these 2 proportions, the proportion specifying visual field testing was significantly different from that specifying corneal cultures(z=-2.328, p<0.0083).
The data suggests that standardized lexicons such as (SNOMED (systemized nomenclature of medicine)) should include ophthalmic testing instructions to ophthalmology technicians in order to increase efficiency and validity of the testing results in electronic workflow. Further study of frequency of repeat testing as a result of miscommunication between doctor and technician needs to be investigated as it is not only time consuming but also extremely costly.
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