Electronic reminders to facilitate longitudinal care: a mixed-methods study in general practices

Area of Science:

• Health Informatics
• General Practice
• Patient Care Management

Background:

• Longitudinal, patient-centered care presents challenges for general practitioners (GPs).
• Reminder systems integrated into electronic health records (EHRs) can support GPs in managing complex patient needs.
• This study investigates the characteristics and utilization of reminder systems in German GP practices.

Purpose of the Study:

• To identify the content, display modes, visual appearance, and responsibilities associated with EHR reminders in general practice.
• To assess the extent to which GPs utilize reminders for patient recall and comprehensive care management.
• To evaluate the effectiveness and identify areas for improvement in current reminder system functionalities.

Main Methods:

• A mixed-methods approach combining a cross-sectional survey of 185 GP practices with structured observations in six practices.
• Survey data analyzed using descriptive statistics to summarize reminder usage and characteristics.
• Observations focused on reminder utilization for a clinical vignette of a multimorbid senior patient with 26 care needs.

Main Results:

• 98.6% of surveyed practices use EHR reminders, frequently addressing allergies, preventive measures, and chronic diseases.
• Reminders were mainly self-configured, displayed variably (separate fields, scattered, pop-ups), and featured diverse visual elements (colors, symbols, traffic lights).
• Practices utilized reminders for an average of 13.3 out of 26 care aspects, requiring a mean of 27.5 minutes to retrieve information.

Conclusions:

• Most general practices employ self-designed, visual EHR reminders for specific care elements.
• Current reminder systems are often fragmented and require significant time for information retrieval.
• There is a need for more sophisticated, data-driven reminder solutions to optimize longitudinal patient care.