EHR-generated alerts limit unneeded tests: study

A computerized alert curbed rates of unnecessary blood testing among elderly patients and reduced physicians' reliance on an often-inaccurate diagnostic test, according to a new study from Kaiser Permanente's Institute for Health Research.

The D-dimer test, a tool used to help diagnose deep vein thrombosis and pulmonary embolism, is only 35% accurate in patients over 65 years of age. In response, researchers implemented an alert within Kaiser's electronic health record, which advised physicians of the test's high rate of false-positives and suggested an alternate test.

After the alert was in place, the rate of D-dimer tests ordered for older patients dropped nearly 70%, to 1.52 per 1,000 patient visits from 5.02, a result that was later replicated when the alert was implemented in the control group clinics.

“Physicians sometimes find it hard to remember to follow evidence-based clinical practice guidelines,” said Ted Palen, a clinical researcher at the institute and lead author of the study, in a news release. “Many people have suggested that computer-generated alerts within electronic medical records may serve as reminders to improve adherence to best practices.”