title: The effect of automated alerts on preoperative anemia management.
abstract: OBJECTIVE
  This study evaluated the role of an automated anemia notification system that alerted providers about anemic pre-operative patients.
  
  
  METHODS
  After scheduling surgery, the alert program continuously searched the patient's laboratory data for hemoglobin value(s) in the medical record. When an anemic patient according to the World Health Oganization's criteria was identified, an email was sent to the patient's surgeon, and/or assistant, and/or patient's primary care physician suggesting that the anemia be managed before surgery.
  
  
  RESULTS
  Thirteen surgeons participated in this pilot study. In 11 months, there were 70 pre-surgery anemia alerts generated on 69 patients. The surgeries were 60 orthopedic, 7 thoracic, 2 general surgery, and 1 urological. The alerts were sent 15 ± 10 days before surgery. No pre-operative anemia treatment could be found in 37 of 69 (54%) patients. Some form of anemia management was found in 32 of 69 (46%) patients. Of the 23 patients who received iron, only 3 of 23 (13%) of these patients started iron shortly after the alert was generated. The alert likely resulted in the postponement of one surgery for anemia correction.
  
  
  CONCLUSIONS
  Although anemia diagnosis and management can be complex, it was hoped that receipt of the alert would lead to the management of all anemic patients. Alerts are only effective if they are received and read by a healthcare provider empowered to treat the patient or to make an appropriate referral.
  
  
  CONCLUSIONS
  Automated preoperative alerts alone are not likely to alter surgeons' anemia management practices. These alerts need to be part of a comprehensive anemia management strategy.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dilla
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Wisniewski
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Waters
authors.forename: Darrell J
authors.initials: DJ
authors.lastname: Triulzi
authors.forename: Mark H
authors.initials: MH
authors.lastname: Yazer
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D019468:Disease Management; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D057234:Preoperative Period
keywords: Alert; Anemia; Automated; Management; Notification; Peri-operative