| Abstract | BACKGROUND: Although they are effective in outpatient settings, computerized reminders have not
been proved to increase preventive care in inpatient settings. METHODS: We conducted a randomized,
controlled trial to determine the effects of computerized reminders on the rates at which four preventive
therapies were ordered for inpatients. During an 18-month study period, a computerized system processed
on-line information for all 6371 patients admitted to a general-medicine service (for a total of 10,065
hospitalizations), generating preventive care reminders as appropriate. Physicians who were in the
intervention group viewed these reminders when they were using a computerized order-entry system for
inpatients. RESULTS: The reminder system identified 3416 patients (53.6 percent) as eligible for
preventive measures that had not been ordered by the admitting physician. For patients with at least one
indication, computerized reminders resulted in higher adjusted ordering rates for pneumococcal vaccination
(35.8 percent of the patients in the intervention group vs. 0.8 percent of those in the control group,
P<0.001), influenza vaccination (51.4 percent vs. 1.0 percent, P< 0.001), prophylactic heparin (32.2
percent vs. 18.9 percent, P<0.001), and prophylactic aspirin at discharge (36.4 percent vs. 27.6 percent,
P<0.001). CONCLUSIONS: A majority of hospitalized patients in this study were eligible for preventive
measures, and computerized reminders significantly increased the rate of delivery of such therapies. |