Protocol-based computer reminders, the quality of care and the non-perfectability of man

• HIT Description: Computerized decision support with reminders; Electronic health record More info...
  
• Purpose of Study: Determine whether clinical errors can be reduced by prospective computer suggestions about the management of simple clinical events
  
• Years of study: 1975-Not available
  
• Study Design: RCT
  
• Outcomes: Impact on patient safety, Impact on health care effectivness/quality
  

• Settings: Nine physicians from a general medicine clinic in Indiana participated in the investigation.
• Intervention: The use of a protocol of computer suggestions about the management of simple clinical events such as management of elevated blood pressure was compared to not using a protocol.
• Evaluation Method: Measure of physicians' response to reminders.
• Description: The protocols of computer suggestions were part of ÒThe Regenstrief Medical RecordÓ system, which accepts protocols written by physicians, and uses them to evaluate the management of clinical events.
• Quality of Care and Patient Safety Outcome: Physicians responded to 51 per cent of 327 events when given, and 22 per cent of 385 events when not given computer suggestions (P0.00001). There were significant differences between groups regarding the type of event: P0.0016 for Type I (observe a physical finding/inquire about a symptom), P0.00001 for Type II (order a diagnostic study), and P0.0076 for Type III (change/initiate a therapeutic regimen).