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Computerized Alerts Improve Outpatient Laboratory Monitoring of Transplant Patients

^a Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT
^b Department of Medical Informatics, Intermountain Healthcare, Salt Lake City, UT
^c Liver, Kidney, Pancreas Transplant Program, LDS Hospital, Salt Lake City, UT

^_* Correspondence: Catherine J. Staes, BSN, MPH, PhD, Department of Biomedical Informatics, University of Utah, HSEB suite 5515E, 26 South 2000 East, Salt Lake City, Utah, 84112 (Email: Catherine.Staes{at}hsc.utah.edu).

Received for publication: 08/30/07; accepted for publication: 01/22/08.

Authors evaluated the impact of computerized alerts on the quality of outpatient laboratory monitoring for transplant patients. For 356 outpatient liver transplant patients managed at LDS Hospital, Salt Lake City, this observational study compared traditional laboratory result reporting, using faxes and printouts, to computerized alerts implemented in 2004. Study alerts within the electronic health record notified clinicians of new results and overdue new orders for creatinine tests and immunosuppression drug levels. After implementing alerts, completeness of reporting increased from 66 to >99 %, as did positive predictive value that a report included new information (from 46 to >99 %). Timeliness of reporting and clinicians' responses improved after implementing alerts (p <0.001): median times for clinicians to receive and complete actions decreased to 9 hours from 33 hours using the prior traditional reporting system. Computerized alerts led to more efficient, complete, and timely management of laboratory information.