Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics

J Am Med Inform Assoc. 2003 Nov-Dec;10(6):541-6. doi: 10.1197/jamia.M1353. Epub 2003 Aug 4.

Abstract

More than 20% of approximately 35,000 patients filling a diuretic prescription had no potassium blood test recorded within the previous year. A laboratory reporting system used throughout Israel by Maccabi Healthcare Services physicians was modified to provide physician alerts regarding potassium testing. The physicians were experienced users of a computerized medical record (CMR) that provided online laboratory test results. A nightly batch file checked pharmacy diuretic purchases against the patient's potassium blood test status. On-screen computer-generated reminders were sent to physicians of patients lacking a recent potassium test. Reminders to clinicians increased potassium testing by 9.8% (p < 0.001). Physician age and gender played a small part in predicting compliance to the alert, but specialty and practice size did not. The time delay between the date a reminder was sent and the potassium test date decreased steadily during the intervention. The success of this reminder system encourages expansion to include more drug-laboratory interactions. Furthermore, direct alerts to patients at multiple organization/patient contact points are planned.

Publication types

  • Evaluation Study

MeSH terms

  • Ambulatory Care Information Systems
  • Clinical Laboratory Information Systems*
  • Clinical Pharmacy Information Systems
  • Diuretics / adverse effects*
  • Diuretics / therapeutic use
  • Humans
  • Israel
  • Medical Records Systems, Computerized*
  • Potassium / blood*
  • Preventive Health Services
  • Reminder Systems*

Substances

  • Diuretics
  • Potassium