EMR reminders to improve preventive care for the elderly

January 01, 0001

EMR reminders to improve preventive care for the elderly

Most elderly patients do not receive recommended preventive care, acute care, and care for chronic conditions. These US authors conducted a controlled trial to assess the effectiveness of electronic medical record (EMR) reminders, with or without panel management, on health care proxy designation, osteoporosis screening, and influenza and pneumococcal vaccinations in patients older than 65 years. Physicians were assigned to 1 of the following 3 arms: EMR reminder, EMR reminder plus panel manager, or control. They assessed completion of recommended practices during a 1-year period.

They found: "Among patients who had not already received the recommended care, health care proxy was designated in 6.5% of patients in the control arm, 8.8% of the EMR reminder arm, and 19.7% of the EMR reminder plus panel manager arm. Bone density screening was completed in 17.7% of patients in the control arm, 19.7% of the EMR reminder arm, and 30.5% of the EMR reminder plus panel manager arm. Pneumococcal vaccine was given to 13.1% of patients in the control arm, 19.5% of the EMR reminder arm, and 25.6% of the EMR reminder plus panel manager arm. Influenza vaccine was given to 46.8% of patients in the control arm, 56.5% of the EMR reminder arm, and 59.7% of the EMR reminder plus panel manager arm. Results were similar when adjusted for individual physician performance in the preceding year, patient age, patient sex, years cared for by the practice, and number of visits."

The authors concluded: "Electronic medical record reminders alone facilitated improvement in vaccination rates and, when augmented by panel management, facilitated further improvement in vaccination rates and boosted the rates of health care proxy designation and bone density screening."

Interesting to note that electronic reminders alone are not enough to increase rates for the more complex services.

For the full abstract, click here.

Arch Intern Med 171(17):1552-1558, 26 September 2011 © 2011 to the American Medical Association
Electronic Medical Record Reminders and Panel Management to Improve Primary Care of Elderly Patients. Timothy S. Loo, Roger B. Davis, Lewis A. Lipsitz, et al. Correspondence to Dr. Loo: tloo@bidmc.harvard.edu

Category: HSR. Health Services Research Keywords: preventive services, elderly, electronic records, reminders, vaccination, bone densitometry, health care proxy, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 11 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.