A computerized reminder system to increase the use of preventive care for hospitalized patients.
BACKGROUND
Although they are effective in outpatient settings, computerized reminders have not been proved to increase preventive care in inpatient settings.


METHODS
We conducted a randomized, controlled trial to determine the effects of computerized reminders on the rates at which four preventive therapies were ordered for inpatients. During an 18-month study period, a computerized system processed on-line information for all 6371 patients admitted to a general-medicine service (for a total of 10,065 hospitalizations), generating preventive care reminders as appropriate. Physicians who were in the intervention group viewed these reminders when they were using a computerized order-entry system for inpatients.


RESULTS
The reminder system identified 3416 patients (53.6 percent) as eligible for preventive measures that had not been ordered by the admitting physician. For patients with at least one indication, computerized reminders resulted in higher adjusted ordering rates for pneumococcal vaccination (35.8 percent of the patients in the intervention group vs. 0.8 percent of those in the control group, P<0.001), influenza vaccination (51.4 percent vs. 1.0 percent, P< 0.001), prophylactic heparin (32.2 percent vs. 18.9 percent, P<0.001), and prophylactic aspirin at discharge (36.4 percent vs. 27.6 percent, P<0.001).


CONCLUSIONS
A majority of hospitalized patients in this study were eligible for preventive measures, and computerized reminders significantly increased the rate of delivery of such therapies.
Dexter
P R
PR
Department of Medicine, Indiana University School of Medicine, Regenstrief Institute for Health Care, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis 46202, USA.
Perkins
S
S
Overhage
J M
JM
Maharry
K
K
Kohler
R B
RB
McDonald
C J
CJ
D001241:Aspirin / Q000627:therapeutic use; D018890:Chemoprevention / Q000706:statistics & numerical data; D020000:Decision Support Systems, Clinical; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D007252:Influenza Vaccines; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D022242:Pneumococcal Vaccines; D011315:Preventive Medicine; D011322:Primary Prevention / Q000706:statistics & numerical data; D017010:Reminder Systems
D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines; D006493:Heparin; D001241:Aspirin