title: Use of electronic health record-based tools to improve appropriate use of the human papillomavirus test in adult women.
abstract: OBJECTIVE
  To determine whether compliance with guidelines for cervical cancer screening, particularly use of the human papillomavirus (HPV) test in adult (aged ≥21 y) women, improves with the implementation of educational prompts in the electronic health record (EHR).
  
  
  METHODS
  Two EHR-based interventions aimed at reducing unindicated HPV tests were implemented in the EHR in late June 2010. The Pap order form was revised with a descriptor next to the cotest (Pap plus HPV test) option advising that this is not for screening in women younger than 30 years, and a link to the American Society for Colposcopy and Cervical Pathology Web site was made available on the EHR home page. Charts of adult women with HPV results from January to December 2010 were reviewed. Appropriateness of HPV test ordering before (period A: from January to June) and after (period B: from July to December) the interventions were compared using the χ(2) test of association.
  
  
  RESULTS
  A total of 3,564 HPV tests were performed on adult women at Loyola University Medical Center in 2010. During period A, 1,709 tests were ordered compared with 1,855 tests ordered during period B (p = .014). The proportion of HPV tests without an appropriate indication decreased significantly after the EHR changes (20% for period A vs 13% for period B, p < .0005). This significant decrease was seen in both primary care (22% in period A vs 12% in period B, p < .0005) and obstetrics and gynecology (Ob/Gyn) (19% vs 13%, p < .0005).
  
  
  CONCLUSIONS
  Electronic health record-based tools improve compliance with cervical cancer screening guidelines.
authors: Stritch School of Medicine, Loyola University Chicago, Maywood, IL.
authors: Vance
authors: V
authors: Broach
authors: Lyndsey
authors: L
authors: Day
authors: Benjamin
authors: B
authors: Barenberg
authors: Stella
authors: S
authors: Huang
authors: Kimberly
authors: K
authors: Kenton
authors: Paula
authors: P
authors: White
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D061809:Human Papillomavirus DNA Tests / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012189:Retrospective Studies; D055815:Young Adult