Article Figures & Tables
Figures
Figure 1: Results of literature search. *Excluded topics included expert systems (e.g., artificial intelligence or neural network applications) for facilitating diagnosis or for estimating prognosis; decision support not directly related to patient care (e.g., coding medical records); and reminders directed primarily at nonphysicians.
Figure 2: Median absolute improvements in adherence to processes of care between intervention and control groups in each study. Each study is represented by the median and interquartile range for its reported outcomes; studies with single data points reported only one eligible outcome.
Figure 3: Median effects for adherence to processes of care by study feature. *Kruskall–Wallis test; all other p values reflect Mann–Whitney test. †Quasi-RCT refers to randomized controlled trials in which intervention status was assigned on the basis of an arbitrary but not truly random process, such as even or odd patient (or provider) identification numbers. ‡The total number of comparisons for the analysis of sample size is 31 because one study did not report the number of patients. §Studies classified as having no cointervention were those in which a computer reminder alone was compared with usual care; studies classified as having co-interventions were those in which the intervention group received a computer reminder plus one or more other quality improvement interventions, while the control group received those same quality improvement interventions but no computer reminder.
Figure 4: Median effects for adherence to processes of care by reminder feature. *Underuse = targeting improvements to increase the percentage of patients who receive targeted process of care (e.g., increasing the percentage of patients receiving the influenza vaccine); overuse = targeting improvements to reduce the percentage of patients receiving inappropriate care (e.g., reducing the percentage of patients who receive antibiotics for viral upper respiratory tract infections). †Reminders with no patient-specific information were those triggered on the basis of demographic characteristics (e.g., age) or the intent to order a medication or investigation irrespective of any features of the patient involved or patient-specific laboratory results. The sample size is reduced because of the inability to accurately assess the presence or absence of the feature. ‡Active delivery refers to reminders that appeared automatically when triggering conditions were met, as opposed to passive reminders, where, for instance, users might be presented with the option to click on a link to receive decision support related to their current task. §CPOE = computerized order entry system; reminder systems without CPOE were typically electronic medical record systems.
Tables
Table 1: Description of 28 studies (32 comparisons) included in a systematic review of the effects of point-of-care computer reminders on physician behaviour (part 1 of 3)
Table 1: Description of 28 studies (32 comparisons) included in a systematic review of the effects of point-of-care computer reminders on physician behaviour (part 2 of 3)
Table 1: Description of 28 studies (32 comparisons) included in a systematic review of the effects of point-of-care computer reminders on physician behaviour (part 3 of 3)
Table 2: Improvements in adherence to processes of care across the 28 studies (32 comparisons) included in the review
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- Computer reminders to clinicians during routine activities produce only small improvements in adherence to processes of care: median improvement 4.2%, IQR 0.8-18.8%