Smart Alert System Help Busy Doctors Remember

To develop the system, the researchers used existing software tools that were available in a commercial EHR system, which were integrated with physician performance reports into the EHR. When a recommended treatment is not the medically right choice for a patient, the attending physician is able to enter that information into the EHR; thus, he is not needlessly reminded that the patient is not getting a certain drug.

To test the system, the researchers enrolled 40 primary care physicians at Northwestern Memorial Hospital (NMH; Chicago, IL, USA), and monitored their performance and information input into the EHR as a result of the system alerts. The researchers found that after one year, the software program significantly improved primary care physicians' performance and the health care of patients with such chronic conditions as diabetes and cardiovascular disease. Among the improvements noted were the lowering of cholesterol medication dosages in heart disease patients, a rise in pneumonia vaccinations (from 80 to 90%), and a rise in colon cancer screenings (from 57 to 62%). The study was published early online on December 21, 2010, in the journal Medical Care.

"It helps us find needles in the haystack and focus on patients who really have outstanding needs that may have slipped between the cracks," said lead author Stephen Persell, MD, an assistant professor in the division of general internal medicine at NMH. "Quality health care is not just about having good doctors and nurses taking care of you; it's having systems in place that make it easier for them to do their jobs and insure that patients get what they need."

"What matters is how you use the electronic health records, so they make your job easier rather than act as a source of constant annoyance and false alarms," added Dr. Persell. "By showing only things that appear to be out of order, we are trying not to overwhelm the physician. If doctors get inaccurate alerts saying do this, do that, then they will ignore them."

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