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Electronic records help boost elders’ preventive care

By Chelsea Conaboy
Globe Staff / October 3, 2011

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Researchers at Beth Israel Deaconess Medical Center found that primary care doctors could improve preventive care for elderly patients by creating reminders in their electronic records system.

The researchers developed a tool that prompted physicians to check whether patients over age 65 had assigned a health care proxy, been screened for osteoporosis, or had received vaccines for flu and pneumonia.

The study included 54 physicians, about one-third of whom followed their usual practices with their existing records. The others were given the reminder tool; half of those were given help by an administrative assistant who contacted patients with reminders.

The study found that electronic reminders alone improved vaccination rates. When paired with the assistant’s help, they significantly increased the number of patients who assigned a health care proxy and were screened for bone density. The authors said the study showed a team-based approach to using electronic health records could improve care.

BOTTOM LINE: Electronic records systems improved preventive care for elderly patients, particularly with help from support staff.

CAUTIONS: The study did not randomly assign physicians to study groups, but divided them by office location, so office characteristics could have influenced the results. The study was conducted at Beth Israel Deaconess offices only.

WHERE TO FIND IT: Journal of the American Medical Association, Sept. 26.

Repeat anesthesia before age 2 tied to learning disabilities

A study by researchers at the Mayo Clinic found that children exposed to anesthesia during repeat surgeries before the age of 2 were more than twice as likely to develop a learning disability before age 19 related to math, reading, or written language than children who have no exposure.

There was no significant increase in risk for those children who had just one exposure.

The study compared children born in Rochester, Minn., between 1976 and 1982, including 700 who had no anesthesia exposure before age 2 and 350 who did. In the latter group, 64 children had more than one exposure.

The researchers found that multiple exposures were associated with significantly lower scores on standardized cognitive tests.

“We cannot exclude the possibility that multiple exposures to anesthesia/surgery at an early age may adversely affect human neurodevelopment with lasting consequence,’’ they said.

BOTTOM LINE: Children who were repeatedly exposed to anesthesia before the age of 2 had a higher risk of developing a learning disability before age 19.

CAUTIONS: One anesthetic included in the study, halothane, is no longer in widespread use and may have had different effects from those used today. During the study period, Rochester was primarily white and had a higher income than the national average.

WHERE TO FIND IT: Pediatrics, November

Chelsea Conaboy can be reached at cconaboy@boston.com.

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