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Comment & Response
Less Is More
June 2019

Effectiveness of a Best Practice Alert to Reduce Telemetry Orders—Reply

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco, San Francisco
JAMA Intern Med. 2019;179(6):844-845. doi:10.1001/jamainternmed.2019.0705

In Reply We are grateful to Garneau and colleagues for their interest in our study.1 We agree that a best practice alert, by itself, appears to have a smaller effect size than multimodal interventions in the reduction of unnecessary cardiac monitoring. We highlighted this in the Discussion section of the article: “It therefore appears that the effect size from only making changes to the [electronic health record] is smaller than what can be expected from including other elements typical of quality improvement interventions….”1(p14) We also agree that the success of our intervention was likely because of, in large part, its careful targeting in accordance with the 5 “rights” of clinical decision support.2

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