Computer-generated reminders and quality of pediatric HIV care in a resource-limited setting

Martin C. Were, Winstone M. Nyandiko, Kristin T.L. Huang, James E. Slaven, Changyu Shen, William M. Tierney, Rachel C. Vreeman

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Objectives: To evaluate the impact of clinician-targeted computergenerated reminders on compliance with HIV care guidelines in a resource-limited setting. Methods: We conducted this randomized, controlled trial in an HIV referral clinic in Kenya caring for HIV-infected and HIV-exposed children (,14 years of age). For children randomly assigned to the intervention group, printed patient summaries containing computer-generated patientspecific reminders for overdue care recommendations were provided to the clinician at the time of the child's clinic visit. For children in the control group, clinicians received the summaries, but no computergenerated reminders. We compared differences between the intervention and control groups in completion of overdue tasks, including HIV testing, laboratory monitoring, initiating antiretroviral therapy, and making referrals. Results: During the 5-month study period, 1611 patients (49% female, 70% HIV-infected) were eligible to receive at least 1 computergenerated reminder (ie, had an overdue clinical task). We observed a fourfold increase in the completion of overdue clinical tasks when reminders were availed to providers over the course of the study (68% intervention vs 18% control, P < .001). Orders also occurred earlier for the intervention group (77 days, SD 2.4 days) compared with the control group (104 days, SD 1.2 days) (P < .001). Response rates to reminders varied significantly by type of reminder and between clinicians. Conclusions: Clinician-targeted, computer-generated clinical reminders are associated with a significant increase in completion of overdue clinical tasks for HIV-infected and exposed children in a resource-limited setting.

Original languageEnglish (US)
Pages (from-to)e789-e796
JournalPediatrics
Volume131
Issue number3
DOIs
StatePublished - Mar 2013

Keywords

  • Decision support
  • Developing countries
  • Electronic health records
  • HIV
  • Pediatrics
  • Quality of care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

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    Were, M. C., Nyandiko, W. M., Huang, K. T. L., Slaven, J. E., Shen, C., Tierney, W. M., & Vreeman, R. C. (2013). Computer-generated reminders and quality of pediatric HIV care in a resource-limited setting. Pediatrics, 131(3), e789-e796. https://doi.org/10.1542/peds.2012-2072