White P, et al. – Researchers sought to determine whether the 2011 electronic health record (EHR) changes led to improved compliance with cervical cancer screening and management of abnormal results in adolescent (<21 y) patients, and found that implementation of two new prompts was associated with lower rates of unindicated Pap testing in adolescents but did not improve providers choosing the correct Pap type.
Methods
- Two EHR prompts were implemented in May 2011.
- The first is a bright yellow alert that pops up whenever a Pap test is ordered in a patient younger than 21 years, recommending against routine screening.
- The second was a change in wording of the Pap order form, indicating that if Pap testing is done, human papillomavirus (HPV) testing is not appropriate in this age group.
Results
- The overall rate of Pap testing decreased after the EHR changes (86/759 [11.3%] before vs 69/1,274 [5.4%] after, P<0.0005).
- The rate of Pap testing without a valid indication such as a 12–month follow–up of previous abnormal results also decreased (66/759 [8.7%] before vs 49/1,274 [3.8%] after, P<0.0005).
- Most Pap tests (77%, both before and after EHR changes) were ordered with reflex HPV testing if atypical squamous cells of undetermined significance.
- Use of the correct Pap order type (Pap alone, no HPV test) did not improve (16/86 [18.6%] vs 15/69 [22%], P=0.0857). Source
