Pediatricians' responses to printed clinical reminders

Does highlighting prompts improve responsiveness?

Kristin S. Hendrix, Stephen Downs, Aaron Carroll

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective Physicians typically respond to roughly half of the clinical decision support prompts they receive. This study was designed to test the hypothesis that selectively highlighting prompts in yellow would improve physicians' responsiveness. Methods We conducted a randomized controlled trial using the Child Health Improvement Through Computer Automation clinical decision support system in 4 urban primary care pediatric clinics. Half of a set of electronic prompts of interest was highlighted in yellow when presented to physicians in 2 clinics. The other half of the prompts was highlighted when presented to physicians in the other 2 clinics. Analyses compared physician responsiveness to the 2 randomized sets of prompts: highlighted versus not highlighted. Additionally, several prompts deemed high priority were highlighted during the entire study period in all clinics. Physician response rates to the high-priority highlighted prompts were compared to response rates for those prompts from the year before the study period, when they were not highlighted. Results Physicians did not respond to prompts that were highlighted at higher rates than prompts that were not highlighted (62% and 61%, respectively; odds ratio 1.056, P =.259, NS). Similarly, physicians were no more likely to respond to high-priority prompts that were highlighted compared to the year before, when the prompts were not highlighted (59% and 59%, respectively, χ2 = 0.067, P =.796, NS). Conclusions Highlighting reminder prompts did not increase physicians' responsiveness. We provide possible explanations why highlighting did not improve responsiveness and offer alternative strategies to increasing physician responsiveness to prompts.

Original languageEnglish
Pages (from-to)158-164
Number of pages7
JournalAcademic Pediatrics
Volume15
Issue number2
DOIs
StatePublished - Mar 1 2015

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Physicians
Clinical Decision Support Systems
Pediatricians
Automation
Primary Health Care
Randomized Controlled Trials
Odds Ratio
Pediatrics

Keywords

  • alert fatigue
  • clinical decision support
  • pediatric
  • prompts
  • reminders

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Pediatricians' responses to printed clinical reminders : Does highlighting prompts improve responsiveness? / Hendrix, Kristin S.; Downs, Stephen; Carroll, Aaron.

In: Academic Pediatrics, Vol. 15, No. 2, 01.03.2015, p. 158-164.

Research output: Contribution to journalArticle

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N2 - Objective Physicians typically respond to roughly half of the clinical decision support prompts they receive. This study was designed to test the hypothesis that selectively highlighting prompts in yellow would improve physicians' responsiveness. Methods We conducted a randomized controlled trial using the Child Health Improvement Through Computer Automation clinical decision support system in 4 urban primary care pediatric clinics. Half of a set of electronic prompts of interest was highlighted in yellow when presented to physicians in 2 clinics. The other half of the prompts was highlighted when presented to physicians in the other 2 clinics. Analyses compared physician responsiveness to the 2 randomized sets of prompts: highlighted versus not highlighted. Additionally, several prompts deemed high priority were highlighted during the entire study period in all clinics. Physician response rates to the high-priority highlighted prompts were compared to response rates for those prompts from the year before the study period, when they were not highlighted. Results Physicians did not respond to prompts that were highlighted at higher rates than prompts that were not highlighted (62% and 61%, respectively; odds ratio 1.056, P =.259, NS). Similarly, physicians were no more likely to respond to high-priority prompts that were highlighted compared to the year before, when the prompts were not highlighted (59% and 59%, respectively, χ2 = 0.067, P =.796, NS). Conclusions Highlighting reminder prompts did not increase physicians' responsiveness. We provide possible explanations why highlighting did not improve responsiveness and offer alternative strategies to increasing physician responsiveness to prompts.

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