Promoting screening mammography in inner-city settings. The sustained effectiveness of computerized reminders in a randomized controlled trial

• HIT Description: Computerized decision support with reminders. More info...
  
• Purpose of Study: Assess the effectiveness of a computerized reminder system in promoting mammography.
  
• Years of study: 1989-1991
  
• Study Design: RCT
  
• Outcomes: Impact on health care effectivness/quality
  

• Settings: Three primary care practices of a Health Department and a health maintenance organization in Detroit, Michigan participated in the study.
• Intervention: Eliminating out-of-pocket mammography cost (limited intervention) and receiving computer-generated reminders promoting physician referral for mammography were placed in the medical records of women due for mammography 1 month in advance of their due date (full intervention) was compared to just the limited intervention.
• Evaluation Method: Measures of mammography rates
• Quality of Care and Patient Safety Outcome: Among 1,225 year 2 visitors, mammography rates were 44% for full intervention versus 28% for limited intervention at the health department (adjusted odds ratio [OR] for effect of full intervention 1.84; 95% confidence interval [CI]: 1.40-2.40) and 45% for full versus 46% for limited at the health maintenance organization (adjusted OR 1.06; 95% CI 0.80-1.42). These second year results contrasted with those observed for year 1, during which a significant effect of full intervention was demonstrated for both organizations. After controlling for patient characteristics and site, the effect sizes of full intervention were reduced significantly in the second year compared with the first year (P = 0.05).