Reminders to physicians from an introspective computer medical record. A two-year randomized trial

C. J. McDonald, S. L. Hui, D. M. Smith, W. M. Tierney, S. J. Cohen, M. Weinberger, G. P. McCabe

Research output: Contribution to journalArticle

460 Scopus citations

Abstract

We developed a computer-stored medical record system containing a limited set of the total clinical data base - primarily diagnostic studies and treatments. This system responds to its own content according to physician- authored reminder rules. To determine the effect of the reminder messages generated by 1,490 rules on physician behavior, we randomly assigned practitioners in a general medicine clinic to study or control groups. The computer found indications for six different actions per patient in 12,467 patients during a 2-year study: 61 study group residents who received computer reminders responded to 49% of these indications; 54 control group residents, to only 29% (p < 0.0001). Preventive care (occult blood testing, mammographic screening, weight reduction diets, influenza and pneumococcal vaccines) was affected. The intentions of the study group to use a given action for an indication predicted their response to the indications (p < 0.03, r2 = 0.33). The intentions of the control residents did not.

Original languageEnglish
Pages (from-to)130-138
Number of pages9
JournalAnnals of Internal Medicine
Volume100
Issue number1
StatePublished - 1984

ASJC Scopus subject areas

  • Medicine(all)

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    McDonald, C. J., Hui, S. L., Smith, D. M., Tierney, W. M., Cohen, S. J., Weinberger, M., & McCabe, G. P. (1984). Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Annals of Internal Medicine, 100(1), 130-138.