BACKGROUND: Automated health maintenance reminder (HMR) systems embedded in electronic medical records systems have been found to improve utilization of preventive services, but underuse persists. Our goal was to learn how to make HMRs more effective by measuring clinicians' self-reported use of HMRs and attitudes toward an HMR system embedded in an electronic medical record. METHODS: We surveyed 43 clinicians using an electronic medical record with an automated HMR system that prompted the provision of preventive or screening interventions. We measured general attitudes toward computers and the HMR, attitudes toward health maintenance, reactions to key features of the HMR system, and use of information provided by the HMR system; and we asked open-ended responses on how to improve the system. RESULTS: Seventy-five percent of clinicians reported not observing or paying attention to the HMR flashing reminder icon when reviewing a chart, and 62.8% reported they either ignored or forgot to address an alert when it appeared. Only 20% reported regularly reviewing health maintenance needs of the patient before the clinical encounter, and 56% reported seldom or never acting on HMR information during an encounter that was not health maintenance. CONCLUSIONS: This HMR system embedded in an electronic medical record was underused by clinicians, causing lost opportunities for provision of preventive care. As electronic medical records become more common, we need to find practical ways that are acceptable to clinicians to use the new capabilities the systems provide.
BACKGROUND: Automated health maintenance reminder (HMR) systems embedded in electronic medical records systems have been found to improve utilization of preventive services, but underuse persists. Our goal was to learn how to make HMRs more effective by measuring clinicians' self-reported use of HMRs and attitudes toward an HMR system embedded in an electronic medical record. METHODS: We surveyed 43 clinicians using an electronic medical record with an automated HMR system that prompted the provision of preventive or screening interventions. We measured general attitudes toward computers and the HMR, attitudes toward health maintenance, reactions to key features of the HMR system, and use of information provided by the HMR system; and we asked open-ended responses on how to improve the system. RESULTS: Seventy-five percent of clinicians reported not observing or paying attention to the HMR flashing reminder icon when reviewing a chart, and 62.8% reported they either ignored or forgot to address an alert when it appeared. Only 20% reported regularly reviewing health maintenance needs of the patient before the clinical encounter, and 56% reported seldom or never acting on HMR information during an encounter that was not health maintenance. CONCLUSIONS: This HMR system embedded in an electronic medical record was underused by clinicians, causing lost opportunities for provision of preventive care. As electronic medical records become more common, we need to find practical ways that are acceptable to clinicians to use the new capabilities the systems provide.
Authors: Steven J Atlas; Richard W Grant; William T Lester; Jeffrey M Ashburner; Yuchiao Chang; Michael J Barry; Henry C Chueh Journal: J Gen Intern Med Date: 2010-09-15 Impact factor: 5.128
Authors: Chris Feifer; Lynne Nemeth; Paul J Nietert; Andrea M Wessell; Ruth G Jenkins; Loraine Roylance; Steven M Ornstein Journal: Ann Fam Med Date: 2007 May-Jun Impact factor: 5.166
Authors: Annette Moxey; Jane Robertson; David Newby; Isla Hains; Margaret Williamson; Sallie-Anne Pearson Journal: J Am Med Inform Assoc Date: 2010 Jan-Feb Impact factor: 4.497
Authors: William T Lester; Jeffrey M Ashburner; Richard W Grant; Henry C Chueh; Michael J Barry; Steven J Atlas Journal: J Am Med Inform Assoc Date: 2008-12-11 Impact factor: 4.497