Do computerized reminders help deliver better care?

January 01, 0001

Do computerized reminders help deliver better care?

On of the promises of clinical information systems is the use of computerized reminders to aid physicians in delivering care to patients. These Canadian and British investigators conducted a systematic review to quantify the magnitude of improvements in processes of care from computer reminders delivered to clinicians during their routine patient care activities. They utilized the MEDLINE, Embase and CINAHL databases (to July 2008) and scanned the bibliographies of retrieved articles. They included randomized or quasi- randomized studies to evaluate improvements in processes or outcomes of care.

The researchers report: "Among the 28 trials (reporting 32 comparisons) included in our study, we found that computer reminders improved adherence to processes of care by a median of 4.2% (interquartile range {IQR} 0.8%-18.8%). Using the best outcome from each study, we found that the median improvement was 5.6% (IQR 2.0%-19.2%). A minority of studies reported larger effects; however, no study characteristic or reminder feature significantly predicted the magnitude of effect except in one institution, where a well- developed, "homegrown" clinical information system achieved larger improvements than in all other studies (median 16.8% {IQR 8.7%-26.0%} v. 3.0% {IQR 0.5%-11.5%}). A trend toward larger improvements was seen for reminders that required users to enter a response (median 12.9% {IQR 2.7%-22.8%} v. 2.7% {IQR 0.6%-5.6%})."

The authors concluded: "Computer reminders produced much smaller improvements than those generally expected from the implementation of computerized order entry and electronic medical record systems. Further research is required to identify features of reminder systems consistently associated with clinically worthwhile improvements."

Computerized reminders have only modest benefits in assisting physicians deliver care to patients

For the full abstract, click here.

Canadian Medical Association Journal 182(5): E216, 23 March 2010 © 2010 Canadian Medical Association
Effect of point-of-care computer reminders on physician behaviour: a systematic review. Kaveh G. Shojania, Alison Jennings, Alain Mayhew, Craig Ramsay, Martin Eccles, and Jeremy Grimshaw. Correspondence to Kaveh G. Shojania: [email protected]

Category: HSR. Health Services Research. Keywords: computerized reminder, electronic medical record, clinical information system, point of care, adherence, systematic review, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 13 April 2010

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