Electronic alerts tied to EMRs and evidence-based guidelines can result in a sharp reduction in unnecessary diagnostic testing, but only if the alerts are timely, concise and properly targeted, a new Kaiser Permanente study suggests.

The study, conducted on 788,000 patients at eight primary-care clinics in Colorado, and reported in the November issue of the American Journal of Managed Care, found that the rate of ordering "D-dimer" tests for detecting blood clots declined by nearly 70 percent among patients 65 and older when physicians received alerts. The alerts noted that the D-dimer test returns high rates of false positives for deep vein thrombosis and pulmonary embolism in older patients.

"The issue is that if you're ordering a test that doesn't give you good information, why order it?" lead author Dr. Ted Palen says, according to Computerworld. "We didn't embark on this to show how we can save on testing costs. We want to advise clinicians how to follow good evidence-based medicine guidelines."

But physicians often tune out alerts when they are too frequent, a situation known as "alert fatigue," so it is important for the warnings to be directly relevant to patients. "As the healthcare industry moves to widely adopt EMR technology, it is critical that physicians and other caregivers are given specific and relevant data at the point of care to avoid alert fatigue," Palen says in a press release.

"This study shows that delivering a very targeted electronic message for a particular patient profile can result not only in better use of the test in question, it can alter a physician's ordering behavior and promote improved adherence to a clinical practice guideline. This finding is important when designing systems that will support better coordination of patient care," adds Palen.

To learn more about this study:
- take a look at this Fast Company story
- check out this Computerworld article
- read this Kaiser Permanente press release

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