Effectiveness of computer-generated reminders for increasing discussions about advance directives and completion of advance directive forms. A randomized, controlled trial

• HIT Description: A computer based nursing care plan system; Electronic health record More info...
  
• Purpose of Study: To determine the effects of computer generated reminders to physicians on rates of advanced directive discussions and rates of subsequent establishment of advance directive plans.
  
• Years of study: Not Available
  
• Study Design: A randomized control trial.
  
• Outcomes: Frequencies of advanced directive discussions and rates of advance directive plans being established.
  

• Settings: A primary care practice of an academic medical center.
• Intervention: A computerized reminder aimed at physicians incorporated into a comprehensive electronic health record.
• Evaluation Method: 1009 patients and 147 physcians randomized in a 2x2 factorial design.
• HIT System: A comprehensive electronic health record.
• Implementation:  Physicians in the clinic were using the existing EHR and receiving reminders at baseline. While generated by the computer system, the reminders were viewed by physicians on paper flow sheets which summarized the encounter.
• Clinical Outcomes: The rates of advanced directive discussions and rates of documented advanced directive plans.
• Benefits: Reminders increased the rates of advanced directive discussions per eligible patient encounter by a 20% (24% vs. 4%) and increased establishment of an advanced care plane by 11% (15% vs. 4%).