Northwestern Medicine researchers achieved notable reductions in unnecessary testing using EHR alerts. The study demonstrated substantial decreases in unnecessary prostate-specific antigen testing, urine testing, and prescription of hypoglycemic agents. EHR alerts resulted in an 8.7% decrease in PSA testing, a 5.5% reduction in urine testing, and a 1.4% decline in overtreating blood sugar. The study’s focus on potential harms, social norms, and social accountability contributed to designing effective alerts. This contrasts with limited success in changing clinician behavior through other research. Lead author Stephen Persell underscores the importance of incorporating these elements for effective alerts.
Examining older men for prostate cancer may not significantly prolong their lives, but it may expose them to potential harms from unnecessary treatments like surgery or radiation. These treatments could lead to issues such as urinary problems, sexual dysfunction, or rectal bleeding. A parallel risk exists when testing women for urinary tract infections and treating older adults with diabetes using blood glucose-lowering drugs, potentially resulting in dangerous outcomes.
