Variation in implementation and use of computerized clinical reminders in an integrated healthcare system.

Constance H. Fung, Juliet N. Woods, Steven M. Asch, Peter Glassman, Bradley Doebbeling

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

OBJECTIVES: To identify patterns of use of computerized clinical reminders (CCRs) across an integrated healthcare system and describe institutional factors associated with their implementation. STUDY DESIGN: Cross-sectional study. METHODS: At a national electronic health record (EHR) meeting, we surveyed 261 participants from 104 Veterans Health Administration (VHA) healthcare facilities regarding the number and types of CCRs available at each facility. Potential explanatory measures included perceived utility and ease of use of CCRs, training and personnel support for computer use, EHR functionalities, and performance data feedback to providers at each facility. RESULTS: The number of conditions with CCRs in use at a facility ranged from 1 to 15; most reported implementation of reminders for 10 of the 15 conditions surveyed. The most commonly implemented CCRs, used in more than 85% of facilities, were for conditions with VHA national performance measures (eg, tobacco cessation, immunizations, diabetes mellitus). The least commonly implemented CCRs were for post-deployment health evaluation and management, medically unexplained symptoms, and erectile dysfunction. Facilities that had implemented greater numbers of clinical reminders had providers who reported greater ease of use and utility of the reminders (P= .01). CONCLUSIONS: VHA facilities vary markedly in their implementation of CCRs. This effect may be partly explained by greater incorporation of clinical reminders for conditions with performance measures. Further study is needed to determine how to best implement clinical reminders and the institutional factors important in their use.

Original languageEnglish (US)
Pages (from-to)878-885
Number of pages8
JournalAmerican Journal of Managed Care
Volume10
Issue number11 Pt 2
StatePublished - Nov 2004
Externally publishedYes

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Veterans Health
United States Department of Veterans Affairs
Electronic Health Records
Delivery of Health Care
Tobacco Use Cessation
health
Training Support
Health Facilities
Erectile Dysfunction
institutional factors
Immunization
Diabetes Mellitus
Cross-Sectional Studies
electronics
performance
Health
cross-sectional study
functionality
nicotine
chronic illness

ASJC Scopus subject areas

  • Medicine(all)
  • Nursing(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Variation in implementation and use of computerized clinical reminders in an integrated healthcare system. / Fung, Constance H.; Woods, Juliet N.; Asch, Steven M.; Glassman, Peter; Doebbeling, Bradley.

In: American Journal of Managed Care, Vol. 10, No. 11 Pt 2, 11.2004, p. 878-885.

Research output: Contribution to journalArticle

Fung, Constance H. ; Woods, Juliet N. ; Asch, Steven M. ; Glassman, Peter ; Doebbeling, Bradley. / Variation in implementation and use of computerized clinical reminders in an integrated healthcare system. In: American Journal of Managed Care. 2004 ; Vol. 10, No. 11 Pt 2. pp. 878-885.
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