Effect of Electronic Health Record Prompts on the Frequency of Blood Lead Tests

Area of Science:

• Pediatric Health
• Public Health
• Health Informatics

Background:

• Elevated blood lead levels pose significant risks to children's cognitive and behavioral development.
• Despite established screening guidelines, many eligible children do not undergo necessary blood lead level testing.
• Identifying barriers and facilitators to screening is crucial for effective public health interventions.

Purpose of the Study:

• To evaluate the impact of electronic health record (EHR) prompts on blood lead test orders for children with government insurance.
• To assess whether EHR-based reminders improve adherence to lead screening recommendations.

Main Methods:

• A retrospective observational study comparing blood lead test ordering and completion rates before and after EHR prompt implementation.
• The study focused on children with government insurance at 12-month and 24-month well-child visits.
• Statistical analysis was used to determine significant changes in screening rates.

Main Results:

• The introduction of EHR prompts did not lead to an increase in ordered blood lead tests.
• A significant decrease in lead screening rates was observed at 12-month well-child visits post-prompt implementation (63.6% to 53.8%).
• Completion rates for blood lead tests also significantly decreased at 12-month visits, with no significant change at 24-month visits.

Conclusions:

• EHR prompts were not effective in increasing blood lead level testing rates in this population.
• The study highlights a potential decline in screening effectiveness, necessitating further investigation into influencing factors.
• Additional research is required to identify strategies that can successfully improve lead screening rates.