May 2002

Document Type


Degree Name



Dept. of Medical Informatics and Outcomes Research


Oregon Health & Science University


Electronic medical record alerts and reminders are increasingly relied upon as a means of decreasing medical errors and increasing the quality and cost-effectiveness of care. They may serve as useful memory aids and draw attention to a variety of situations in which safety, quality, or optimal utilization of scare resources might otherwise be compromised. However, clinicians indicate that alerts and reminders can either help or hinder. Discerning the elements that determine which they will do, and the requirements of a helpful alert or reminder was the focus of this study. Three focus groups consisting of a total of 16 participants were convened. These included 10 male and 6 female primary care clinicians. There were 3 pediatric, 8 family medicine, and 5 internal medicine specialists, 13 physicians, 2 physician assistants, and nurse practitioner. The mean duration of time with Kaiser Permanente was 9.5 years, with a range of from 1 to 24.5 years. All participants had access to the electronic medical record in their exam rooms. Focus groups were recorded and transcripts were iteratively coded and analyzed for themes that would help illuminate characteristics of a helpful alert or reminder. Five themes emerged: Efficiency, Usefulness, Information Content, User Interface, and Workflow. In addition there were New Ideas and Surprises. Following a question-by-question summary of responses, each theme is described in detail and supported with illustrative excerpts. This is followed by a summation of requirements and further discussion.




School of Medicine



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