Study to examine effectiveness of clinical reminders

A study funded by the National Institutes of Health (NIH) will look at the impact of EHR clinical reminders on the quality of primary care.

David Chan, MD, assistant professor at Stanford School of Medicine, has received an NIH Early Independence Award to study these reminders that include a variety of provider messages on medications, follow-up testing and referrals.

“On the one hand, electronic reminders can present helpful information to support better patient care,” Chan, also a physician scientist at Veterans Affairs Palo Alto Health Care, wrote in his research proposal. “On the other hand, given the limits of human cognitive processing and attention, there is the distinct possibility that reminders may overburden clinicians with too much information. There is currently little empirical evidence weighing the benefits and burdens of increasing the informational content of systems of electronic reminders.”

Chan’s research will focus on the Veterans Health Administration (VHA) which is the nation’s largest healthcare delivery system serving about 9 million enrollees at 150 hospitals and 819 community-based outpatient clinics.

NIH Director Francis Collins, MD, wrote in a blog post that the organization will provide “an excellent window into the real-world experiences of doctors, nurses and other healthcare professionals accustomed to working with electronic reminders.” Collins also said that Chan's preliminary research shows that the same type of healthcare provider caring for the same type of patient may have to process "as few as five or as many as 40 electronic reminders relating to preventive care and disease management.” 

Chan aims to determine how many reminders are too many and how many are too few, as well as look into their topic breadth, complexity and comprehensibility, according to Collins. Most importantly, he says Chan will analyze the impact of all of these factors upon the productivity and efficiency of healthcare professionals and the quality of care received by patients.

The NIH Director’s Early Independence Award is designed to support research for outstandingly talented early career researchers to move rapidly into independent research positions at U.S. institutions by essentially omitting the traditional post-doctoral training period.