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First published April 2, 2004 as JAMIA PrePrint; doi:10.1197/jamia.M1531
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J Am Med Inform Assoc. 2004;11:278-280. DOI 10.1197/jamia.M1531.
© 2004 American Medical Informatics Association

Case Report

Computerized Reminders Reduce the Use of Medications during Shortages

Benjamin Bogucki, BS, Brian R. Jacobs, MD, John Hingle, RPH and the Clinical Informatics Outcomes Research Group

Affiliations of the authors: Division of Critical Care Medicine (BB, BRJ) and Pharmacy Department (JH), Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.

Correspondence and reprints: Brian R. Jacobs, MD, Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229; e-mail: <jacobs{at}chmcc.org>.

Received for publication: 01/09/04; accepted for publication: 03/14/04.

Medication shortages pose serious problems in health care. This study examines the impact of a computer-based reminder in addressing a national methylprednisolone shortage. An alert was designed and implemented in a computerized order entry platform at a children's hospital. The alert informed physicians of the shortage and provided an alternative prescribing pathway. Data regarding the number and type of parenteral corticosteroid prescriptions were collected for a one-month period before and after the alert was implemented. The alert resulted in a 55% relative reduction in methylprednisolone use and an average reduction of more than three orders each day. Dexamethasone and hydrocortisone, the recommended alternative medications, increased in use by 12% and 49%, respectively. The alert resulted in a $36,552 annualized cost reduction to the institution. Similar alert applications have great potential for effectively altering physician prescribing behavior.




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