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Methods of Documentation V: CBE01:23

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Effect of an Electronic Health Record Decision Support Alert to Decrease Excess Cervical Cancer Screening.

Deanna Teoh1, Rachel I Vogel1, Adam Langer1

  • 1Department of Obstetrics, Gynecology & Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.

Journal of Lower Genital Tract Disease
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PubMed
Summary
This summary is machine-generated.

An electronic health record alert did not reduce unnecessary cervical cancer screening in women over 65 or post-hysterectomy. Further efforts are needed to optimize clinical decision support for appropriate screening practices.

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Area of Science:

  • Gynecology
  • Preventive Medicine
  • Health Informatics

Background:

  • Cervical cancer screening is frequently performed beyond established guidelines.
  • Over-screening poses risks and increases healthcare costs.

Purpose of the Study:

  • To assess the impact of an electronic health record (EHR) clinical decision support alert on reducing guideline-nonadherent cervical cancer screening.
  • Specifically targeting screening in women over 65 or post-hysterectomy.

Main Methods:

  • A comparative study analyzed Pap test orders before and after EHR alert implementation.
  • Guideline-nonadherent tests were defined as those in women younger than 21, older than 65, or post-hysterectomy.
  • Generalized estimating equation models were used to compare proportions and analyze provider characteristics.

Main Results:

  • The proportion of guideline-nonadherent Pap tests remained similar before (62%) and after (63%) alert implementation (OR = 1.08).
  • Male providers were more likely to order non-indicated Pap tests (OR = 2.30).
  • A small group of providers accounted for a significant number of non-adherent tests.

Conclusions:

  • The EHR clinical decision support alert was ineffective in decreasing guideline-nonadherent cervical cancer screening.
  • Future optimization of clinical decision support should explore alternative strategies for cervical cancer prevention.