title: Improving adherence to hysterosalpingography after hysteroscopic sterilization using an electronic reminder.
abstract: OBJECTIVE
  The US package labeling of the Essure system (Bayer Healthcare, Whippany, NJ) requires hysterosalpingography (HSG) as a confirmatory test after hysteroscopic sterilization to ensure proper placement and tubal occlusion. Previous studies have shown that implementation of a protocol to track patients after Essure procedures can improve HSG adherence. The primary objective of this study was to investigate whether implementation of an electronic reminder for the office staff increases post-Essure HSG adherence.
  
  
  METHODS
  Retrospective cohort study of patients who underwent the Essure procedure between January 2005 and January 2012 (Canadian Task Force classification II-3).
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Two hundred eleven patients underwent the Essure procedure during the study period.
  
  
  METHODS
  Implementation of an electronic reminder for the office staff.
  
  
  RESULTS
  One hundred thirty-seven (64.9%) patients underwent the procedure before implementation of the electronic reminder, and 74 (35.1%) patients underwent the procedure after implementation. Although the odds of post-Essure HSG adherence increased in the overall (odds ratio [OR] = 1.7; 95% confidence interval [CI], .9-3.2) and faculty practice (OR = 2.1; 95% CI, .2-18.6) patient population, these results were not statistically significant. In contrast, the odds of post-Essure HSG adherence increased by almost 3-fold (OR = 2.9; 95% CI, 1.4-6.3) in the resident clinic patient population (p = .003).
  
  
  CONCLUSIONS
  Implementation of an electronic reminder increases post-Essure HSG adherence in the resident clinic patient population.
authors.affiliation: Obstetrics and Gynecology Healthcare Associates, Riddle Hospital, Media, Pennsylvania.
authors.forename: Semhar
authors.initials: S
authors.lastname: Mahmud
authors.affiliation: Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania. Electronic address: nigelepereira@gmail.com.
authors.forename: Nigel
authors.initials: N
authors.lastname: Pereira
authors.affiliation: Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Taylor
authors.affiliation: Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: Lamar E
authors.initials: LE
authors.lastname: Ekbladh
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007047:Hysterosalpingography / Q000379:methods; D010349:Patient Compliance / Q000706:statistics & numerical data*; D015143:Philadelphia; D017010:Reminder Systems; D012189:Retrospective Studies; D013245:Sterilization, Reproductive / Q000379:methods*
keywords: Adherence; Clinical decision support; Essure; Hysterosalpingogram; Information technology; Sterilization