Patient Care Reminder Modules Demonstration Project. Executive Summary, FinalReport and Appendices

摘要

Computerized reminders may prevent physicians from overlooking patient needs. Weconducted a trial of reminders at a neighborhood health center in Boston for a 3-step sequential protocol for workup and follow-up of low hematocrit patients (n=694) and 3 parallel protocols for screening for breast (n=352), cervical (n=211), and colorectal cancer (n=370). Compliance with the protocol improved for providers receiving reminders for 2 of the hematocrit criteria analyzed (confirming anemia and demonstrating gastrointestinal bleeding); yield of positive findings increased for confirming anemia. For cervical and colorectal cancer screening, reminders were effective only for physicians who actively used the reminder system. Reminders were effective for low hematocrit, where the high risk obligates action. For cancer screening where lower risk makes action more discretionary, reminders were effective only for physicians who used them. Test use by providers receiving reminders did not exceed that required by protocol compliance.