Podcast: The effect of automatically generated reminders delivered to providers on paper on quality of care and patient outcomes

Alongside thousands of Cochrane Reviews showing the beneficial effects of certain healthcare interventions are some that investigate how to organize and deliver this care. In July 2017, Chantal Arditi from Cochrane Switzerland in the Institute of Social and Preventive Medicine in Lausanne, and others updated one of these: a review of computer-generated reminders delivered on paper. We asked her to bring us up to date in this podcast.

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John: Hello, I'm John Hilton, editor of the Cochrane Editorial unit. Alongside thousands of Cochrane Reviews showing the beneficial effects of certain healthcare interventions are some that investigate how to organize and deliver this care. In July 2017, Chantal Arditi from Cochrane Switzerland in the Institute of Social and Preventive Medicine in Lausanne, Switzerland, and others updated one of these: a review of computer-generated reminders delivered on paper. We asked her to bring us up to date in this podcast.

Chantal: Reminders, such as a sticky note on a patient’s chart to remind the doctor to order a blood test, have been used for a long time. Their effects have also been studied in many individual studies, which led the editorial team of the Cochrane Effective Practice and Organization of Care group to decide to examine three categories of reminders, which have major resource and usability implications: onscreen reminders, that are entirely computerized; manual reminders, that involve no computers; and a “hybrid” type that are automatically generated by computer but delivered on paper. These “computer-generated paper reminders” are what we looked at in our review and they include things such as a note printed at the bottom of the patient chart reminding the doctor to perform an overdue test.
35 studies are now included in the review. Since the first version in 2012, we identified three additional studies from France, Israel and Kenya, showing how this research is becoming more global given that most studies in the first version were done in the US and Canada.
We now have moderate quality evidence that reminders probably improve quality of care slightly compared with usual care, by a median of 7%. We also found that implementing reminders alone improved quality of care by 11% compared with usual care, but implementing reminders in addition to another intervention improved care by just 4%. However, it’s still not clear whether reminders have benefits for patient outcomes, because the current evidence on this is of very low quality.
Some of our other findings are that reminders could help doctors provide care that better reflects current guidelines and evidence-based medicine, especially in the field of preventive care; and that providing space on the reminder for the doctor to write a response to the prompts increased its effectiveness.

John: If you’d like to learn more about all the findings in Chantal’s review and watch for future updates, go online to Cochrane Library dot com and search 'computer generated reminders'.

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