A computerized reminder system to increase the use of preventive care for hospitalized patients.

Background: Although they are effective in outpatient settings, computerize d reminders have not been proved to increase preventive care in inpatient s ettings. Methods: We conducted a randomized, controlled trial to determine the effec ts of computerized reminders on the rates at which four preventive therapie s were ordered for inpatients. During an 18-month study period, a computeri zed system processed on-line information for all 6371 patients admitted to a general-medicine service (for a total of 10,065 hospitalizations), genera ting preventive care reminders as appropriate. Physicians who were in the i ntervention group viewed these reminders when they were using a computerize d order-entry system for inpatients. Results: The reminder system identified 3416 patients (53.6 percent) as eli gible for preventive measures that had not been ordered by the admitting ph ysician. 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 tho se 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 pe rcent, P<0.001). Conclusions: A majority of hospitalized patients in this study were eligibl e for preventive measures, and computerized reminders significantly increas ed the rate of delivery of such therapies. (N Engl J Med 2001;345:965-70.) Copyright (C) 2001 Massachusetts Medical Society.