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Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.
Cutrona, Sarah L; Fouayzi, Hassan; Burns, Laura; Sadasivam, Rajani S; Mazor, Kathleen M; Gurwitz, Jerry H; Garber, Lawrence; Sundaresan, Devi; Houston, Thomas K; Field, Terry S.
Afiliación
  • Cutrona SL; Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA. Sarah.Cutrona@umassmed.edu.
  • Fouayzi H; Quantitative Health Sciences and Medicine, Division of Health Informatics and Implementation Science, University of Massachusetts Medical School, Worcester, MA, USA. Sarah.Cutrona@umassmed.edu.
  • Burns L; Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health Worcester, Worcester, MA, USA. Sarah.Cutrona@umassmed.edu.
  • Sadasivam RS; University of Massachusetts Medical School, Worcester, MA, USA. Sarah.Cutrona@umassmed.edu.
  • Mazor KM; Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health Worcester, Worcester, MA, USA.
  • Gurwitz JH; University of Massachusetts Medical School, Worcester, MA, USA.
  • Garber L; Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health Worcester, Worcester, MA, USA.
  • Sundaresan D; University of Massachusetts Medical School, Worcester, MA, USA.
  • Houston TK; Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health Worcester, Worcester, MA, USA.
  • Field TS; University of Massachusetts Medical School, Worcester, MA, USA.
J Gen Intern Med ; 32(11): 1210-1219, 2017 Nov.
Article en En | MEDLINE | ID: mdl-28808942
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3 days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. MAIN MEASURES: Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24 h. KEY RESULTS: At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7 days. Of the 799 alerts, 47.1% were opened within 24 h. Patients with longer hospital stays (>4 days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24 h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24 h (OR 0.18 [CI 0.08-0.39]). CONCLUSIONS: The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Sistemas Recordatorios / Continuidad de la Atención al Paciente / Registros Electrónicos de Salud / Médicos de Atención Primaria Tipo de estudio: Clinical_trials / Diagnostic_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Gen Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Sistemas Recordatorios / Continuidad de la Atención al Paciente / Registros Electrónicos de Salud / Médicos de Atención Primaria Tipo de estudio: Clinical_trials / Diagnostic_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Gen Intern Med Asunto de la revista: MEDICINA INTERNA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos