From the Department of Medicine, Division of General Internal Medicine, University of Florida College of Medicine, Gainesville, and the Department of Biostatistics, University of Kansas Medical Center, Kansas City.
South Med J. 2020 Oct;113(10):475-481. doi: 10.14423/SMJ.0000000000001160.
To determine the association of utilization of health maintenance tables (HMTs) as a provider reminder tool within the electronic medical record with the completion of women's preventive health services.
Guidelines from the US Preventive Services Task Force and the Advisory Committee on Immunization Practices were used to create the HMT. The study sample consisted of female patients between 18 and 74 years of age who visited the University of Florida Internal Medicine Clinic at Medical Plaza between February 15, 2016 and June 24, 2016. We determined whether a reminder system was used for each visit and whether the following preventive health services were up to date: breast cancer screening, cervical cancer screening, and human papillomavirus vaccination. χ tests of independence were performed to compare the number of up-to-date preventive measures associated with each provider reminder type.
We divided the visits into four groups based on the type of provider reminder used: the HMT, the computer-generated reminder .HM, simple annotation, and no reminder. Compared with .HM, no reminder, and all non-HMT, HMT utilization had a statistically significant positive association with the completion of breast and cervical cancer screening and human papillomavirus vaccination. The difference between the HMT and simple annotation groups did not achieve statistical difference, however.
Despite well-established, evidence-based guidelines for screening tests and immunizations effective in reducing cancer-related morbidity and mortality, significant gaps in routine preventive care remain. The HMT may be a provider-friendly and cost-effective reminder tool to enhance the preventive health care of women.
确定在电子病历中使用健康维护表(HMT)作为提供者提醒工具与完成女性预防保健服务之间的关联。
使用美国预防服务工作组和免疫实践咨询委员会的指南创建 HMT。研究样本包括 2016 年 2 月 15 日至 6 月 24 日期间在佛罗里达大学内科诊所医疗广场就诊的 18 至 74 岁之间的女性患者。我们确定每次就诊是否使用了提醒系统,以及以下预防保健服务是否最新:乳腺癌筛查、宫颈癌筛查和人乳头瘤病毒疫苗接种。使用独立性 χ 检验比较与每种提供者提醒类型相关的最新预防措施数量。
我们根据使用的提供者提醒类型将就诊分为四组:HMT、计算机生成的提醒.HM、简单注释和无提醒。与.HM、无提醒和所有非 HMT 相比,HMT 的使用与完成乳腺癌和宫颈癌筛查以及人乳头瘤病毒疫苗接种有统计学显著正相关。然而,HMT 与简单注释组之间的差异未达到统计学差异。
尽管有针对筛查测试和免疫接种的既定、基于证据的指南,这些指南可有效降低癌症相关发病率和死亡率,但常规预防保健仍存在显著差距。HMT 可能是一种对提供者友好且具有成本效益的提醒工具,可增强女性的预防保健。