Impact of electronic reminders on venous thromboprophylaxis after admissions and transfers

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Venous thromboembolism (VTE) is a disease that includes both deep vein thrombosis (DVT) and pulmonary embolism (PE) where thrombosis is the presence of a blood clot. "It is the third most common cardiovascular illness after acute coronary syndrome and stroke." [1] When overlooked, it can result to a long-term hospitalization or tragic death. [1]


The purpose of this study was “to analyze the effect of electronic reminders on thromboprophylaxis rates” [2] in nursing units with admitted and transferred patients. Like most of the illnesses, VTE is preventable through the use of certain prophylaxis, it is hoped that the electronic reminders help ensure that appropriate prophylaxis are given/administered on time.


The authors cover two study periods involving six departments of a university hospital, three of which were randomly selected to display reminders for the second period intervention group. After 6h post admission or transfer, the logic of the CDS is set to check for prophylaxis orders within 0-30 h of patient’s arrival.

Statistical Analysis

Significance was set at levels of p≤0.05. Fisher's exact tests were used for 2×2 contingency tables. Comparisons of continuous variables were performed using the Wilcoxon rank-sum test.

The change in the rate of prophylaxis was set as the primary end point. Calculations were performed using the software R, V.2.15.1 (R Foundation for Statistical Computing, Vienna, Austria).


The results show significant impact on prophylaxis orders placed from 6-24 hrs and increased of 5.3% and 4.1% prophylaxis given to patients on admissions and transfers respectively. “Postponing prophylaxis checks to 6 h after admissions and transfers reduced the number of reminders by 62% and thereby minimized the risk of alert fatigue." [2]


Patient Safety is always the number one priority in the hospital/clinic setting. I like this study because it proves that one of the EHR system’s significant functionality to ensure quality patient care is through the use of CDS Rules, which on this case helps promote awareness of VTE Prevention and avoid potential long-term complications or mortality. Credit to the authors for clear descriptions on its methodologies and results.

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Improving Hospital Venous Thromboembolism Prophylaxis with Electronic Decision Support


  1. 1.0 1.1 Disease Management/Cardiology/Venous-thromboembolism
  2. 2.0 2.1 P E Beeler, E Eschmann, et al. Impact of Electronic Reminders on Venous Thromboprophylaxis after Admissions and Transfers. Jornal of the American Medical Informatics Assoc. 2014. Volume 21, Issue e2: Pp e297 - 303.