Printed reminders for doctors improve health care

In an age when physicians are often short on time and deluged with information, printed reminders about screening tests, vaccinations and other health topics can help them provide care that more closely reflects current medical guidelines and evidence-based medicine, finds a new review from The Cochrane Library.

"In today's health care environment, providers see so many patients and have less time to think and talk to patients, so simple reminders can really help the workflow and ensure providers offer the best available care," said lead author Chantal Arditi, MSc, of the Institute of Social and Preventive Medicine at Lausanne University Hospital in Switzerland.

Reminders should encourage clinicians to recall information or provide helpful information at the right time and place so that it fits smoothly within their usual workflow, the authors said. For example, preventive care reminders can encourage timely vaccinations for eligible patients.

The review found that printed reminders generated by computers improved processes of care, such as test ordering or vaccination rates, by an average of seven percent.

"Many offices use electronic medical records (EMRs) but don't have workstations in every consultation room, so computer-generated reminders delivered on paper can be really useful," Arditi said. "While seeing the patient, the doctor can easily see the reminder on the paper chart that was printed out beforehand and can also write things down—many doctors still like to write notes and use paper. The paper trail habit will probably be around for a long time."

Study authors also considered that different styles of reminders could actually improve their effectiveness, said Arditi. "A reminder that asked the provider to write down a reply also worked better—probably because it increases attention a doctor pays to the reminder."

An explanation for the reminder further heightened its effectiveness, she said, especially with vaccination reminders.

"Health care systems globally struggle to improve the quality of care provided to patients," said Jeremy Grimshaw, Ph.D., senior scientist in the Clinical Epidemiology Program at the Ottawa Hospital Research Institute. "While there is a lot of current interest in the potential of electronic health records to support better care, these can be expensive and logistically challenging to introduce. An example is ensuring there are sufficient accessible workstations within clinical environments. The current review shows that it is possible to achieve similar benefits to electronic health records through the use of paper-based reminders generated from a centralized clinical information system. These may be a cost-effective alternative to electronic health records in some settings."