Jimbo M et al. 2006 "Information technology and cancer prevention."

Reference
Jimbo M, Nease DE, Ruffin MT, et al. Information technology and cancer prevention. CA Cancer J Clin 2006;56(1):26-36.
Abstract
"Information technology is rapidly advancing and making its way into many primary care settings. The technology may provide the means to increase the delivery of cancer preventive services. The aim of this systematic review is to examine the literature on information technology impacts on the delivery of cancer preventive services in primary care offices. Thirty studies met our selection criteria. Technology interventions studied to date have been limited to some type of reminder to either patients or providers. Patient reminders have been mailed before appointments, mailed unrelated to an appointment, mailed after a missed appointment, or given at the time of an appointment. Telephone call interventions have not used technology to automate the calls. Provider interventions have been primarily computer-generated reminders at the time of an appointment. However, there has been limited use of computer-generated audits, feedback, or report cards. The effectiveness of information technology on increasing cancer screening was modest at best. The full potential of information technology to unload the provider-patient face-to-face encounter has not been examined. There is critical need to study these new technologic approaches to understand the impact and acceptance by providers and patients."
Objective
To "examine [how] the literature on information technology impacts on the delivery of cancer preventive services in primary care offices."
Size
not applicable
Type of Health IT
Computerized clinical reminders (CRs) and alerts
Type of Health IT Functions
Health IT functions included cancer screening and prevention.
Workflow-Related Findings
"Systems that automatically prompt users, provide specific recommendations rather than assessments, and provide support at the time of decision making are most successful."
"A review of 131 decision-aids studies reported variable effect. The aids improve people's knowledge of options, create realistic expectations, reduce difficulty in decision making, and increase participation in the process, but the outcomes are only modestly increase[s] in cancer screening."
"Effective [decision support] to increase preventive activities in primary care exist[s], but there is considerable variation in the level of change achieved, with effect sizes usually small or moderate. Tailoring interventions to address specific barriers to change in a particular setting is probably important. Multifaceted interventions may be more effective than single interventions, because more barriers to change can be addressed."
"Requiring providers to respond to computer generated reminders improves their compliance with preventive care protocols."
Study Design
Systematic literature review
Study Participants
An English-language search was conducted in the following databases: MEDLINE (1980 - April 2005); CINAHL (1982 - April 2005); EMBASE (1988 - April 2005); Cochrane Central Register of Controlled Trials (CCRT, 2nd quarter, 2005); and Science Citation Index (SCI; 1980 - April 2005). The searches were focused on the following: "screening of all information systems in office-based practice and primary care; broad/general search on screening and information systems; prevention and health promotion of cancer; use of the electronic health record and cancer screening/prevention; cancer prevention and physician practice patterns; and cancer screening and reminder systems." A total of 30 studies meeting the authors' desired criteria were selected for review.