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Variation In The Use Of Computerized Clinical Reminders In An Integrated National Delivery System
Fung C, Woods JN, Asch S, Doebbeling BN. Variation In The Use Of Computerized Clinical Reminders In An Integrated National Delivery System. Paper presented at: Society of General Internal Medicine Annual Meeting; 2004 May 14; Chicago, IL.
Background: Many studies have shown that computerized clinical reminders may improve compliance with practice guidelines, leading to improved quality of care. Prior studies have also evaluated factors associated with diffusion of information technology into healthcare systems. The purpose of this study was to identify patterns of adoption and implementation of computerized clinical reminders across the Veterans Health Administration and describe facilitating factors and barriers.Methods: At a national meeting convened to discuss the Veterans Health Administration's Computerized Patient Record System (CPRS), we conducted a cross-sectional survey of 261 participants representing 104 Veterans Health Administration facilities . Main outcome measures: number and types of computerized clinical reminders available at each facility. Other measures included: ease of use and usefulness of computerized clinical reminders , training and personnel support for computer use, functionalities of electronic medical record, and availability of performance data feedback to providers.Results: The number of computerized clinical reminders in use ranged from one to fifteen; most facilities reported implementation of ten of the fifteen reminders surveyed. The most common computerized clinical reminders, used in over 85% of facilities, were for those with Veterans Health Administration national performance measures (e.g., tobacco use cessation and immunizations). The least common computerized clinical reminders were for post-deployment health evaluation/management and medically unexplained symptoms. Providers at facilities with a higher number of clinical reminders reported greater ease of use and usefulness of the reminders (Beta = 0.20, p = 0.01).Conclusion: Veterans Health Administration facilities have varying degrees of adoption and implementation of computerized clinical reminders. This effect may be partly explained by incorporation of clinical reminders as performance measures and differences in perceived ease of use and usefulness of computerized clinical reminders at certain facilities.