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Previous Volume 345:965-970 September 27, 2001 Number 13 Next

	Full Text PDF Editorial by James, B. C. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

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.

Source Information

From the Department of Medicine, Indiana University School of Medicine (P.R.D., S.P., J.M.O., K.M., R.B.K., C.J.M.); the Regenstrief Institute for Health Care (P.R.D., S.P., J.M.O., C.J.M.); and the Richard L. Roudebush Veterans Affairs Medical Center (P.R.D., R.B.K.) — all in Indianapolis.

Address reprint requests to Dr. McDonald at the Regenstrief Institute for Health Care, 1050 Wishard Blvd., Indianapolis, IN 46202, or at clem{at}regen.rg.iupui.edu.

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