Background: Prior studies have shown multifaceted interventions that include EHR prompts can reduce the utilization of telemetry monitoring, but it is unclear if EHR prompts alone can reduce utilization.
Study design: Cluster-randomized, control trial.
Setting: November 2016 and May 2017 at a tertiary care medical center on the general medicine service.
Synopsis: The authors designed an EHR prompt for patients ordered for telemetry. The prompt would request the team to either discontinue or continue telemetry. Half of the general medicine teams (representing 499 hospitalizations) were randomized to receive the intervention, and the other half of the general medicine teams (representing 567 hospitalizations) did not receive the intervention. In the intervention group, 62% of prompts were followed by a discontinuation of telemetry. This led to a 17% reduction in the mean hours of telemetry monitoring (50 hours in the control group and 41.3 hours in the intervention group; P = .001). There was no significant difference in the rate of rapid responses or medical emergencies between the two groups.
Bottom line: A targeted EHR prompt alone may lead to a reduction in the utilization of telemetry monitoring.
Citation: Najafi N et al. Assessment of a targeted electronic health record intervention to reduce telemetry duration: A cluster-randomized clinical trial. JAMA Intern Med. 2019 Dec 10;179(1):11-5.
Dr. Biddick is a hospitalist at Beth Israel Deaconess Medical Center and instructor in medicine Harvard Medical School.