J Am Med Inform Assoc - Actionable reminders did not improve performance over passive reminders for overdue tests in the primary care setting.

Tópicos

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Resumo

Actionable reminders (electronic reminders linked to computerized order entry) might improve care by facilitating direct ordering of recommended tests. The authors implemented four enhanced actionable reminders targeting performance of annual mammography, one-time bone-density screening, and diabetic testing. There was no difference in rates of appropriate testing between the four intervention and four matched, control primary care clinics for screening mammography (OR 0.81, 95% CI 0.64 to 1.02), bone-density exams (OR 1.29, 95% CI 0.82 to 2.02), HbA1c monitoring (OR 0.91, 95% CI 0.58 to 1.42) and LDL cholesterol monitoring (OR 1.40, 95% CI 0.76 to 2.59). Of the survey respondents, 79% almost never used the system or were unaware of the functionality. In the 9/228 (3.9%) cases with indirect evidence of mammography reminder use, there was a significantly lower proportion with test performance. Our actionable reminders did not improve receipt of overdue testing, potentially due to limitations of workflow integration.

Resumo Limpo

action remind electron remind link computer order entri might improv care facilit direct order recommend test author implement four enhanc action remind target perform annual mammographi onetim bonedens screen diabet test differ rate appropri test four intervent four match control primari care clinic screen mammographi ci bonedens exam ci hbac monitor ci ldl cholesterol monitor ci survey respond almost never use system unawar function case indirect evid mammographi remind use signific lower proport test perform action remind improv receipt overdu test potenti due limit workflow integr

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