Effect of Electronic Health Record Prompts on the Frequency of Blood Lead Tests

Introduction/Objectives: Elevated blood lead levels can cause impaired cognition and behavioral problems in children. Screening is important for identifying children with elevated blood lead levels, but many children who qualify for screening do not get tested. We aimed to see if the addition of pro...

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Bibliographic Details
Published in:Journal of primary care & community health 2023-01, Vol.14, p.21501319231204438-21501319231204438
Main Authors: Kellund, Anna E., Hentz, Roland C., Cristiani, Valeria, Lynch, Brian A.
Format: Article
Language:English
Subjects:
Behavior problems
Blood
Change agents
Children
Cognitive impairment
Comparative studies
Electronic health records
Government
Health insurance
Lead content
Lead poisoning
Medical screening
Original Research
Primary care
Tests
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Summary:Introduction/Objectives: Elevated blood lead levels can cause impaired cognition and behavioral problems in children. Screening is important for identifying children with elevated blood lead levels, but many children who qualify for screening do not get tested. We aimed to see if the addition of prompts in the electronic health record (EHR) would lead to differences in blood lead tests ordered for children with government insurance. Methods: In May 2018, a prompt was added to our institutional EHR that reminded primary care practitioners to recommend lead testing for patients with government insurance. For this retrospective observational pre-post comparative study, we reviewed the rate of blood lead test orders and completed collection before and after the prompt was introduced. Results: The number of blood lead tests ordered did not increase after prompts were introduced in the EHR; rather, the lead screening rates at 12-month well-child visits decreased from 63.6% to 53.8% (P = .008). The 24-month visit data did not change significantly for the number of lead tests ordered before and after the prompt was introduced in the EHR. The number of lead tests completed showed a significant decrease after the prompt was introduced for the 12-month visit (P 
ISSN:2150-1319
2150-1327
DOI:10.1177/21501319231204438