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One of the main contributions to the improvement of the quality and the effectiveness of healthcare delivery over the years was undoubtedly the integration and progression of Information Technologies (ITs) in health services (Jardim, 2013). The implementation of Information Systems (ISs) became increasingly critical to clinical care and hospital operation since the mid-1960s. Initially, these systems were used for the automation of the financial and accounting functions. Later, some Hospital Information Systems (HISs) included patient diagnoses and other patient information (Pai & Huang, 2011).
Thus, a HIS can be described as a system designed to assist in the management of a large amount of clinical and administrative information of a health institution, automating, collecting and analyzing it, and, consequently, helping to support the decision making. It is crucial for all hospital institutions to have good HIS in operation, because it is essential to manage the number of resources that a hospital has in the best way possible, so hospitals can not only offer the best possible service to the patient, but also have financial profitability (Haux, Ammenwerth, Winter, & Brigl, 2004; Bertolini, Bevilacqua, Ciarapica, & Giacchetta, 2011).
The implementation of the Electronic Health Records (EHR) system marks a new cycle of investments in HIS. EHR is a computerized health system where professionals record patients’ clinical information. It is important to note that EHR goes far beyond the computerization of paper records. These systems help to provide health care, assist the clinical decision-making, evaluate the quality of care provided, assist in research and medical education and bring together all the information about the health care provided to a patient. An EHR may also contain data related to physical examination, hospitalization progress, diagnoses, surgical interventions, introduced and visualized in a structured manner, as well as results of complementary diagnostic tests, as imaging (X-ray, ultrasound). In addition, EHR is being integrated into new and more advanced mechanisms of decision support systems (Carter, 2008; Neto, Dias, Santos, & Peixoto, 2019; Salazar et al., 2013).
These systems integrated/implemented in hospitals are normally distributed and present a high degree of heterogeneity, arising the need to share and exchange information in heterogeneous environments. In this context, interoperability plays a fundamental role, as it allows transparent communication between heterogeneous, autonomous and distributed systems and environments, ensuring the understanding of the process and the exchange of data on both sides (Oliveira, Duarte, Abelha, & Machado, 2018). In this sense, the Agency for Integration, Diffusion and Archive (AIDA) was created and implemented in some Portuguese hospitals. AIDA is a platform developed to ensure the interoperability between HIS and beyond, it also ensures the confidentiality, integrity and availability of data, allowing the dissemination and integration of information generated in a healthcare environment, including information on Complementary Means of Diagnosis and Therapeutic (MCDT) (that includes medical exams and tests results) presented by the AIDA-VIEW platform (Duarte et al., 2010; Duarte, Portela, Abelha, Machado, & Santos, 2011).
There are several studies that point out some practices that could improve the display of test results for health professionals, such as highlighting the exams that still have to be visualized and the existence of groupers so that related exams could be seen together. These practices emerge to overcome the problems occurred in the access to diagnostic tests addressed in previous researches, leading to failure when reviewing and acting on the test results accurately and properly. An accurate reporting of results is always important to ensure that the right decision is made, regardless the various reasons for the exams’ requests (Poon et al., 2004; Singh, Naik, Rao, & Petersen, 2008).