The Effect of Electronic Health Record Prompts on the Lab Ordering Frequency of Clinicians Managing Patients Taking Psychotropic Medications

Abstract

The use of information technology provides a beneficial avenue for integrating CPGs into daily clinical work-flow processes by embedding electronic prompts and/or decision-support tools within EHR systems. These have been shown to increase clinician use of and adherence to evidence-based standards of care. The purpose of this project was to determine if EHRembedded prompts affected the frequency of clinician lab ordering at a community-based mental/behavioral health facility located in the Northeast corner of Kansas. The agency’s PMHNP was the only study participant. A retrospective chart review was conducted to assess clinician lab monitoring practices prior to and immediately after implementation of an EHR– embedded prompt. Analysis of the data indicated that the prompt influenced the provider’s lab ordering behavior at the point of care as evidenced by increasing the provider’s lab ordering frequency by 43% across all patient populations. Data analysis also indicated statistically significant (p < .001) decrease in the frequency of missed opportunities during the patient encounter for the PMHNP to provide or consider additional CPG recommended services that support patient safety and treatment efficacy. The prompt had a positive effect on the PMHNP’s lab monitoring practices, increasing the use of CPGs and established an avenue for further process improvements.