The impact of computerized clinical reminders on physician prescribing behavior: evidence from community oncology practice.
The objective of this study is to examine the impact of a clinical reminder generated by an electronic medical record (EMR) system on physician prescribing behavior in community oncology practice setting. A case-control trial assessing the prescribing rates of erythropoietin by physicians is used. The participants and setting involves a total of 11,644 physician-patient encounters in 2 community oncology practices in the United States during a 21-month period. The intervention is a clinical reminder generated in real time during a physician-patient encounter by an EMR identifying cancer patients with low hemoglobin (Hgb) levels (ie, anemic), that is, patients with Hgb less then 12 g/dL. The main outcome measure is to determine the frequency of erythropoietin prescription by physicians to cancer patients with low Hgb levels. Implementation of a clinical reminder generated by way of an EMR significantly improved the likelihood of low-Hgb patients receiving treatment with erythropoietin. Low-Hgb patients in the experimental clinic during the time that the clinical reminder system was in place were almost twice as likely (ie, adjusted odds ratio = 1.92, P = .008) to have been treated with erythropoietin. The data support the effectiveness of clinical reminders as a way to influence physician prescribing behaviors and potentially improve the quality of patient care. However, we feel that there is a need to investigate the use of reminders in other aspects of cancer care that may be undertreated or when new drugs may be available but are underused.
Kralj
Boris
B
Optx Corporation, Denver, CO, USA.
Iverson
Donald
D
Hotz
Ken
K
Ashbury
Fredrick D
FD
D000368:Aged; D000554:Ambulatory Care Facilities; D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy*; D016022:Case-Control Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D009369:Neoplasms / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017010:Reminder Systems / Q000295:instrumentation / Q000706:statistics & numerical data
D004921:Erythropoietin