Electronic triggers to identify delays in follow-up of mammography: harnessing the power of big data in health care.
Electronic triggers are critical tools for detecting adverse events, diagnostic errors, and other safety hazards. Researchers developed an electronic health record–based trigger tool to identify delays in abnormal mammogram follow-up at Veterans Affairs facilities. The tool was moderately effective in detecting diagnostic and treatment delays (positive predictive value 71%) and rarely failed to identify a delay (negative predictive value 93%). Inability to schedule timely follow-up and other systems issues were the most common sources of delay. This study is a rigorous example of how trigger tools can detect safety hazards and improve timely cancer diagnosis. A recent Annual Perspective describes how electronic health records can both help and hinder patient safety.