| (Reprinted) JAMA, February 2, 2005-Vol
293, No. 5, pages 565-571
Missing clinical data can impede primary
care's information-intensive coordinating function. This cross-sectional
study describes primary care physicians' reports of missing information.
The state-level survey was conducted in 32 primary care clinics in Colorado.
A total of 253 clinicians (about 1614 patient visits) filled out questionnaires
about patient and visit characteristics between May and December, 2003.
Missing information was reported in 220 (13.6%) of the 1614 visits. In
97 (44.0%) of these visits, clinicians said that missing information was
at least "somewhat likely" to adversely affect patients. Laboratory
results were the most common type of missing information in 99 (45%) of
the visits. Clinicians or staff reportedly spent significant time unsuccessfully
searching for missing information (5-10 minutes 25.6%; > 10 minutes,
10.4%). Post-adjustment, missing information was likelier among recent
immigrants, new patients, or those with multiple medical problems. Missing
information was less likely in rural practices and in offices with full
electronic records. Clinicians believed that missing information would
probably result in either delayed care or duplicated service (59.5%).
Further research should focus on validating clinicians' perceptions. Prospective
studies should determine causes and sequelae.