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First published February 28, 2008 as JAMIA PrePrint; doi:10.1197/jamia.M2608
Journal of the American Medical Informatics Association 2008;15(3):324-332
© 2008 American Medical Informatics Association

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Submitted on August 30, 2007
Accepted on January 22, 2008

Computerized alerts improve outpatient laboratory monitoring of transplant patients

Catherine J. Staes BSN, MPH, PhD1*, R. Scott Evans MS, PhD2, Beatriz H.S.C. Rocha MD, PhD3, John B. Sorensen MD4, Stanley M. Huff MD2, Joan Arata RN, BSN5, and Scott P. Narus PhD1

Affiliation of the authors: 1 Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT; Department of Medical Informatics, Intermountain Healthcare, Salt Lake City, UT (at time of study) ; 2 Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT; Department of Medical Informatics, Intermountain Healthcare, Salt Lake City, UT ; 3 Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT ; 4 Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT; Liver, Kidney, Pancreas Transplant Program, LDS Hospital, Salt Lake City, UT (at time of study) ; 5 Liver, Kidney, Pancreas Transplant Program, LDS Hospital, Salt Lake City, UT

* To whom correspondence should be addressed.

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.






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