Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics
Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics
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DOI：
10.1197/jamia.m1353
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发表时间：
2003-11-01
影响因子：
6.4
通讯作者：
Shalev, V
中科院分区：
文献类型：
--
作者：
Hoch, I;Heymann, AD;Shalev, V
在约35，000名服用利尿剂处方的患者中，超过20%的患者在前一年内没有记录钾血液测试。修改了Maccabi Healthcare Services医生在整个以色列使用的实验室报告系统，以提供有关钾检测的医生警报。这些医生都是有经验的计算机化病历（CMR）用户，可以提供在线实验室检查结果。一个夜间批处理文件检查药房利尿剂购买对病人的钾血液测试状态。屏幕上的计算机生成的提醒被发送给医生的病人缺乏最近的钾测试。提醒临床医生增加钾检测9.8%（p < 0.001）。医生的年龄和性别在预测对警报的依从性方面发挥了很小的作用，但专业和实践规模没有。在干预期间，发送提醒的日期与钾检测日期之间的时间延迟稳步下降。这种提醒系统的成功鼓励扩展到包括更多的药物-实验室相互作用。此外，还计划在多个组织/患者接触点直接向患者发出警报。
More than 20% of approximately 35,000 patients filling a diuretic prescription had no potassium blood test recorded within the previous year. A laboratory reporting system used throughout Israel by Maccabi Healthcare Services physicians was modified to provide physician alerts regarding potassium testing. The physicians were experienced users of a computerized medical record (CMR) that provided online laboratory test results. A nightly batch file checked pharmacy diuretic purchases against the patient's potassium blood test status. On-screen computer-generated reminders were sent to physicians of patients lacking a recent potassium test. Reminders to clinicians increased potassium testing by 9.8% (p < 0.001). Physician age and gender played a small part in predicting compliance to the alert, but specialty and practice size did not. The time delay between the date a reminder was sent and the potassium test date decreased steadily during the intervention. The success of this reminder system encourages expansion to include more drug-laboratory interactions. Furthermore, direct alerts to patients at multiple organization/patient contact points are planned.