Pending Laboratory Test Results at the Time of Discharge: A 3-Year Retrospective Comparison of Paper Versus Electronic Test Ordering in Three Emergency Departments

Pending laboratory test results at discharge can have major adverse health outcomes. The availability of test results at discharge may depend on whether the tests were ordered electronically or by using a paper-based system. The aim of this study was to determine the rate of pending test results at time of discharge from Emergency Departments (ED), and compare the rate for paper-based and electronic orders across three EDs in New South Wales, Australia. This retrospective study described 71,466 ED presentations with 357,476 laboratory tests across three years (2014-2016). Only patients who were treated in ED and eventually discharged from ED were included. Most tests were ordered using the electronic system (97.2%, n=347,469). The rate of pending test results was significantly lower for electronic orders (6.6%, n=22,928) than for paper orders (9.7%, n=966): a difference of 3.1%. Similar differences were observed when analysis was done by year of ED presentation. Moreover, in a subgroup analysis that included the top five high volume tests, four of the five tests had significantly lower rates of pending test results for electronic orders than for paper-based orders. The study highlighted an important benefit of ordering tests via electronic system which can potentially improve patient outcomes.