The effect of electronic reminders on the recording of diagnoses in primary care: A quasi-experimental before and after study

Abstract

Objectives: This study examined whether using electronic reminders leads to an increase in the rate of diagnosis recordings in the electronic health record system following visits to a general practitioner. The impact of electronic reminders was studied in the primary health care of a Finnish city. Methods: This observational quasi-experimental study based on a before-and-after design was carried out by installing an electronic reminder to improve the recording of diagnoses in the computerized electronic health record system. The quantity of the recorded diagnoses was observed before and after the intervention. The effect of this intervention on the distribution of different diagnoses was also studied. Results: Before intervention, 33%–46% of visits (to general practitioners/month) had recorded diagnose in the primary health care units. After 4 years, the recording rate had risen to 87%–95% (p < 0.001). The rate of change in the recording of diagnoses was highest during the first year of intervention and plateaued about 3.5 years after application reminders. In the present study, most of the visits concerned mild respiratory infections, elevated blood pressure, low back pain and type 2 diabetes. Conclusion: An electronic reminder is likely to improve the recording of diagnoses during the visits to general practitioners. The distribution of diagnoses was in line with former reports concerning diagnoses in Finnish primary care.

Differences between recorded diagnoses of patients of an emergency department and office-hours primary care doctors: a register-based study in a Finnish town

“…GFS provided a specific place in the EHR where the appropriate diagnosis codes of the 10 th version of the International Classification of Diseases (ICD-10) could be entered during the patients’ visits to the doctors of the ED and GPs. The system assisted the doctors in finding a proper diagnosis code or allowed the doctor to use the right code for the desired diagnosis directly, as described in detail earlier [ 10 , 11 ]…”

“…After that time, the reminders were always active till the end of the follow-up period (December 2014). The GFS-system prompted the ED doctors to enter a diagnosis every time they wanted to close a case [ 10 , 11 ] The follow-up period started in February 2002 and ended in December 2014. In February 2015, the primary care ED was totally outsourced to Helsinki University Hospital (HUS) due to a general restructuring of the local ED system in the HUS-area.…”

Do electronic reminders alter recorded diagnoses in primary care office-hours practices of health centers: A register-based study in a Finnish city

“…The EHR system assists the PCP in assigning an appropriate diagnosis code or allows the physician to enter the desired diagnosis code to the system directly as described in detail earlier. 11 , 12 As a result, it takes between 2 and a few dozen seconds longer for the PCP to record the visit or consultation.…”

“…The GFS system prompted PCPs to enter a diagnosis code every time they wanted to complete the recording of the visit. 11 , 12 The follow-up period started from February 2002 and ended in December 2014.…”

“…Electronic reminders lead to an increase in the rate at which diagnoses are recorded in primary health care visits to PCPs. 11 , 12 Recording diagnoses in primary care is not self-evident because in 2018, less than two-thirds of the visits to the Finnish PCPs contained a recorded diagnosis. 13 Thus, it seemed reasonable to study the relationship of electronic reminders to the contents and quantity of documentation in office-hours primary care health centers (PCHCs).…”