PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Reminder Systems”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1992

Implementing clinical guidelines: a quality management approach to reminder systems.

"Reminders" (timely notices about specific clinical events to physicians or patients) are useful strategies for implementing clinical guidelines. These systems can vary widely in content, design, and purpose. This variability makes it difficult to compare systems or predict a reminder's efficacy in a particular setting. In this article, the authors suggest that too much attention has been paid to proving the efficacy of reminder systems as a general strategy or a comprehensive solution. Rather, the usefulness and effectiveness of reminder systems will be better appreciated when quality management principles are applied to designing, implementing, and maintaining them. Physicians must participate in finding the best solutions for clinical process problems, and reminder systems--when implemented as the "best solution"--must be monitored and improved continually on an ongoing basis to continue to meet physicians' needs.

Feedback↗
PubMed1996

The effectiveness of a mail reminder system for depot medroxyprogesterone injections.

To determine if a mail reminder system leads to an increase in the percentage of depot medroxyprogesterone acetate (Depo-Provera) injections administered on time, the charts of 184 women were reviewed. The reminder postcard included the due dates of both the next medroxyprogesterone injection and the next Papanicolaou test. Timeliness of injections improved with the reminder system from 64% administered on time to 76% (P < .02). Injections given late despite the reminders were late a mean of 8 days. Injections given late before the reminder system began were late a mean of 20 days (P < .05). If injections given during the injection's 14-day "grace" period are included, the on-time rate improved from 87% to 96% with the reminder system (P < .005). The reminder system was not effective in ensuring annual Papanicolaou testing. Vigilance is needed to ensure that women receiving medroxyprogesterone injections also receive timely Papanicolaou testing.

Adult↗
PubMedDate not supplied

A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting.

OBJECTIVE: Computer-based reminder systems have the potential to change physician and patient behaviors and to improve patient outcomes. We performed a meta-analysis of published randomized controlled trials to assess the overall effectiveness of computer-based reminder systems in ambulatory settings directed at preventive care. DESIGN: Meta-analysis. SEARCH STRATEGY: Searches of the Medline (1966-1994), Nursing and Allied Health (1982-1994), and Health Planning and Administration (1975-1994) databases identified 16 randomized, controlled trials of computer-based reminder systems in ambulatory settings. STATISTICAL METHODS: A weighted mixed effects model regression analysis was used to estimate intervention effects for computer and manual reminder systems for six classes of preventive practices. MAIN OUTCOME MEASURE: Adjusted odds ratio for preventive practices. RESULTS: Computer reminders improved preventive practices compared with the control condition for vaccinations (adjusted odds ratio [OR] 3.09; 95% confidence interval [CI] 2.39-4.00), breast cancer screening (OR 1.88; 95% CI 1.44-2.45), colorectal cancer screening (OR 2.25; 95% CI 1.74-2.91), and cardiovascular risk reduction (OR 2.01; 95% CI 1.55-2.61) but not cervical cancer screening (OR 1.15; 95% CI 0.89-1.49) or other preventive care (OR 1.02; 95% CI 0.79-1.32). For all six classes of preventive practices combined the adjusted OR was 1.77 (95% CI 1.38-2.27). CONCLUSION: Evidence from randomized controlled studies supports the effectiveness of data-driven computer-based reminder systems to improve prevention services in the ambulatory care setting.

Ambulatory Care↗
PubMedDate not supplied

The Cancer Prevention Reminder System.

The Cancer Prevention Reminder System is a computer-based system designed to increase the delivery of periodic health maintenance procedures. The program provides printed reminders that identify patients' overdue procedures, prints summary reports of the percentage of patients who are eligible and overdue for a procedure, and prints mailing labels for patients. We performed a randomized, controlled trial in which the effects of computer-based reminders were compared with those of two other interventions among residents in a university-based group practice.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Use of a clinician reminder system for screening mammography in a public health clinic.

Physician reminder systems have been used to increase the appropriate use of clinical preventive services. These systems, though, have been typically tested in resident clinics. We conducted this study, using a time-series design, to determine if a manual clinician reminder system could increase the use of screening mammography in an urban public health clinic. In the one-year baseline period, 47% of women who were due for a mammogram received the procedure; the corresponding percentage in the one-year intervention period was 72% (P < .0000001). The improvement reflected a large increase in appropriate ordering behavior by primary care providers rather than an increase in patient adherence. This study demonstrates that a noncomputerized reminder system can greatly improve the delivery of screening mammography in a public health clinic setting.

Adult↗
PubMed1995

A computer-generated reminder system improves physician compliance with diabetes preventive care guidelines.

Computerized reminder systems have been shown to be effective in improving physician compliance with preventive services guidelines. Very little has been published about the use of computerized reminders for preventive care in diabetes. We implemented a computer-generated reminder system for diabetes care guidelines in a randomized controlled study in the outpatient clinics of 35 internal medicine residents at the University of Utah and Salt Lake Veterans Affairs Hospitals. After a six month study period, compliance with the recommended care significantly improved in both the intervention group that received patient-specific reminders about the guidelines (38.0% at baseline, 54.9% at follow-up) and the control group that received a nonspecific report (34.6% at baseline, 51.0% at follow-up). There was no significant difference between the two groups. Both clinic sites showed similar improvement over baseline levels of compliance. Residents who completed encounter forms used by the system showed a significantly greater improvement in compliance than those who did not complete encounter forms (19.7% vs. 7.6%, p = 0.006). The improvements in guideline compliance were seen in all areas of diabetes preventive care studied, and significant improvements were seen with recommended items from the medical history, physical exam, laboratory testing, referrals, and patient education. The use of encounter forms by the providers significantly improved documented compliance with the guidelines in almost all categories of preventive care. These results suggest that computerized reminder systems improve compliance with recommended care more by facilitating the documentation of clinical findings and the ordering of recommended procedures than by providing the clinician with patient-specific information about guideline compliance status. Further study is needed to understand the implications of these findings to the development of future computerized reminder systems for chronic diseases such as diabetes.

Analysis of Variance↗
PubMed1994

Improving a preventive services reminder system using feedback from focus groups.

OBJECTIVE: To improve the computer-generated preventive services patient reminder letter used by a department of family medicine at a medical university in South Carolina. DESIGN: A qualitative method chosen because of its demonstrated efficacy in generating in-depth attitude and opinion data was used for 12 focus groups (111 participants) in which participants were asked to evaluate the reminder letter and other preventive services reminder materials. Information from these groups was used to design a revised patient reminder system that was tested in six additional focus groups (50 participants). SETTING: University-based family medicine center. PARTICIPANTS: Adults 19 years of age or older of whom approximately one half were selected from a random sample of family medicine center patients and the remainder from volunteers recruited from the general community by newspaper advertisement. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Participants' perceptions and attitudes about the reminder letter and other materials as well as suggestions for improving the preventive services reminder system. RESULTS: The revised patient reminder materials resulted in a warmer, more personal letter sent to patients at the time of their birthdays in an envelope containing a prevention message. A leaflet describing the rationale for preventive services and answering common questions about prevention and a booklet describing the preventive services available at the family medicine center were also developed. CONCLUSION: This study illustrated the benefits of incorporating patients' perspectives in the design of preventive services reminders.

Adult↗
PubMed1984

A nurse-initiated reminder system for the periodic health examination. Implementation and evaluation.

Implementation of specific health maintenance recommendations into practice settings has been difficult. We introduced a nurse-initiated health maintenance reminder system into a university-based internal medicine practice setting. We then compared performance of selected items (Papanicolaou smear, stool examination for occult blood, breast examination, and influenza immunization) in the practice before and after institution of the system. The system required no additional personnel and was quickly learned by the nursing staff. There were significant increases in the performance of stool examination for occult blood (32% to 47%), breast examination (29% to 46%), and influenza immunization (18% to 40%) after the reminder system was introduced. A nurse-initiated health maintenance reminder system is a feasible and effective method for implementing periodic health examination procedures into a practice setting.

Aged↗
PubMed1996

An office system for organizing preventive services: a report by the American Cancer Society Advisory Group on Preventive Health Care Reminder Systems.

Despite increasing recognition of the importance of preventive services, such services are not provided in primary care practice as often as recommended. One of the most important reasons is the lack of a systematic, organized approach within practices. The American Cancer Society Ad Hoc Advisory Group on Preventive Health Care Reminder Systems reviewed evidence-based reports and expert opinion to summarize current knowledge about office systems for clinical preventive services. This article describes the process of developing an office system for preventive care, beginning with writing a practice policy, auditing charts for baseline performance, developing and implementing a plan for efficient delivery of preventive care, involving office staff, and monitoring progress. Strategies for dissemination of this approach to a wide range of primary care practices may involve professional medical organizations and managed care companies.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Can computerized reminder systems have an impact on preventive services in practice?

This report reviews computerized reminder systems for tracking health maintenance in clinical practice and discusses the features of a useful, cost-effective system. Systems presently available are predominantly designed for large groups. The primary product of these systems is a health maintenance status report for the provider that is generated at each patient visit. Systems for smaller groups that will generate reminders for providers and patients at specified appropriate intervals and will easily send reminders to patients who do not have appointments or are inactive are not available. Necessary features of such "ideal" computerized tracking systems include: 1) Demographic data must be obtainable from the practice's billing system and not require separate data entry. 2) Data entry must be quick, preferably single-screen. 3) Multiple-entry options must be available for each procedure. 4) The system must generate reminders regardless of whether a patient has an appointment. 5) Providers must be able to specify or cancel patient reminders. 6) A status report must be created for the chart at specified intervals. 7) The frequency and description of indicated procedures must be modifiable without programmer assistance.

Ambulatory Care Information Systems↗
PubMed1986

Evaluation of a computerized reminder system in the enhancement of patient medication refill compliance.

This study evaluated the use of a computerized patient profile combined with a reminder system to increase refill compliance of patients on cardiovascular medications. There were 311 patients randomly assigned into one of three groups. Patients in group 1 were monitored for refill compliance only. Group 2 patients received a postcard reminder; group 3 patients received a telephone call reminder. Refill compliance was monitored via the computerized patient profile system for a period of three months. Data collection included refill compliance, reasons for noncompliance, and the number of prescription medications for each patient. There was a significant difference between the overall mean rate of compliance between the control and intervention groups. An increase in refill compliance for all groups occurred over three months. There was no significant difference in compliance between the treatment groups. Overall, the medication reminder system appeared to be effective; however, modifications in the system should be pursued.

Ambulatory Care↗
PubMed1995

The effects of a computer-assisted reminder system on patient compliance with recommended health maintenance procedures.

In June of 1993 we implemented a computer-assisted reminder system in the outpatient clinic of an 18 resident family practice training program. The system notifies both patients and physicians of recommended health maintenance procedures. In the 22 months following implementation we documented a rapid increase in physician and patient compliance with several disease screening and prevention services. Despite high physician compliance, we were unable to increase patient compliance rates above 70% for any procedure. At the end of the study period patient compliance varied from a low of 26.7% for sigmoidoscopy to a high of 61.7% for pneumococcal pneumonia vaccination. We feel this study has important implications for the US Public Health Service's preventive services screening goals for the year 2000.

Ambulatory Care Facilities↗
PubMedDate not supplied

An appointment reminder system's effect on reducing the number of hypertension patients who drop out from care.

We evaluated the effects of an appointment reminder system on the appointment-keeping behavior and blood pressure control status of hypertensive patients receiving care in an urban medical clinic. The study population consisted of 973 adult hypertensive patients receiving medical care at a family practice clinic affiliated with the Wayne State University School of Medicine, Detroit, Michigan. Of the 973 patients enrolled in the study, 486 were randomly assigned to a group that received appointment reminder cards and telephone calls to reschedule missed appointments, and 487 were assigned to a nonintervention control group. Patients were followed-up with regard to their appointment-keeping behavior and blood pressure control status, five to eight months after being entered in the study. The study results indicate that patients in the appointment reminder group kept significantly more appointments and were less likely to drop out of treatment than patients in the control group. The dropout rate was 46 percent lower among patients in the appointment reminder group than in the control group. Patients in the appointment reminder group also demonstrated slightly better blood pressure control at the end of the study compared with patients in the control group, although none of the differences in blood pressure levels between groups were statistically significant at the 5 percent level.

Adult↗
PubMed1992

Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance.

Fewer than 10% of children with moderate or severe asthma receive an annual influenza vaccination despite their heightened susceptibility to severe infections and recommendations by the American Academy of Pediatrics and the Immunization Practices Advisory Committee that all such children be vaccinated annually. Patient, provider, and system factors leading to this poor vaccination rate are not well understood. This study tested the effectiveness of a computerized reminder system in improving influenza vaccination rates in children with asthma and examined patient barriers to vaccination at one pediatric clinic in an urban teaching hospital. A computer database identified 124 children with moderate or severe asthma. Patients were randomly assigned either to study group (n = 63), who were sent a personalized letter reminder about the need for an influenza vaccination, or to a control group (n = 61), who received no reminder. Study group mothers were interviewed 2 months after the letter was sent to assess factors associated with receipt of vaccination, including demographic features, parental worry about asthma and vaccine side effects, the four dimensions of the Health Belief Model, and health locus of control beliefs. Nineteen study group patients (30%) received an influenza vaccination, compared with only 4 control patients (7%) (P < .01). Forty-three mothers of children in the study group were interviewed; 14 (33%) of these children had received the vaccination. Of the characteristics investigated, two significantly correlated with vaccination compliance: high levels of parental worry about asthma (positively correlated: odds ratio = 23.3, P < .01) and high levels of parental worry about vaccine side effects (negatively correlated: odds ratio = 0.087, P = .025).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

One vendor's experience: preliminary development of a reminder system based on the Arden Syntax.

This article reviews the efforts of HBO & Company in the production of a first phase clinical alerting system based on the Arden Syntax. The alerting system was integrated with a clinical data repository and clinical workstation to process returning laboratory results. Investigations with expert systems resulted in a C language alerting system. GUI prototyping of an authoring environment led to a Smalltalk language authoring system. Future development is expected to broaden the system scope and address the evolution of the Arden Syntax.

Artificial Intelligence↗
PubMedDate not supplied

Computerized health maintenance tracking systems: a clinician's guide to necessary and optional features. A report from the American Cancer Society Advisory Group on Preventive Health Care Reminder Systems.

BACKGROUND: To promote preventive health care by primary care physicians and the development of computerized health maintenance tracking systems, the American Cancer Society sponsored an expert advisory group to define necessary and desirable, but optional features of computer-based health maintenance tracking software for use in primary care practice. METHODS: Systematic literature review and structured consensus development were followed by independent expert critique. RESULTS: Necessary input features include a comprehensive, practice-specific health maintenance protocol, multiple entry codes to indicate the current status of each procedure, and a mechanism for patient-specific exclusion or alteration of procedure frequency. Necessary features of the information management system include a linkage to a demographic data system, optional tracking of all or selected patients, identification of each patient's primary provider, and the ability to provide either a paper or electronic interface for the provider. Necessary outputs include provider reminders, patient reminders sent regularly regardless of visit status, and summary reports of provider and patient compliance. CONCLUSIONS: Although the ideal computer-based health maintenance tracking system is still evolving, knowledge of these necessary and optional features can aid clinicians interested in buying or developing a system for their own practice.

Preventive Medicine↗