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Can EHR Alerts Reduce Cardiac Monitoring?

JAMA Intern Med; ePub 2018 Dec 10; Najafi, et al

A targeted electronic health record (EHR) alert can safely reduce unnecessary cardiac monitoring by prompting discontinuation when appropriate, a new study found. In the cluster-randomized clinical trial, the EHR alert was randomized to half of the teams on the general medicine service of the Division of Hospital Medicine at the University of California, San Francisco Medical Center, and included physicians of 12 inpatient medical teams (6 intervention, 6 control). The primary outcome was telemetry monitoring hours per hospitalization. Physician responses to the alert were collected using EHR reporting tools. Among the findings:

  • There were 1,021 patients included in the study.
  • There were 499 hospitalizations analyzed in the intervention arm and 567 in the control arm.
  • The alert prompted a significant reduction in telemetry monitoring duration with no significant change in rapid-response calls or medical emergency events.
  • The most common physician response to the alert was to discontinue telemetry monitoring (62% of 200 alerts).

Citation:

Najafi N, Cucina R, Pierre B, Khanna R. Assessment of a targeted electronic health record intervention to reduce telemetry duration. A cluster-randomized clinical trial. [Published online ahead of print December 10, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.5859.

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