Yes, we CAM: Increasing physician communication about complementary and alternative medicine through electronic medical record prompts in a pediatric hospital

Background and purpose: Over half of patients utilize complementary and alternative medicine (CAM), yet fewer than 10 % of physicians inquire about use. This prospective cohort study sought to increase patient-provider communication about CAM through electronic medical record (EMR) prompts and education, as well as study concordance rates of physician and nursing CAM-related documentation. Materials and methods: Recordings in history and physical (H&P) documents authored by first-year pediatric residents were used as a proxy for communication. Rates of documentation were assessed at baseline, after the introduction of an EMR prompt, and after an educational intervention. Nursing documentation was compared with resident documents to assess rates of concordance regarding CAM-related documentation. Results: Baseline CAM-related documentation rate was 24 % and increased to 50 % after introducing an EMR CAM prompt (p < 0.001). No significant change occurred after education: 38 % had CAM-related documentation (p = 0.09). Physician and nursing documentation concordance rates were 58 % at baseline, 48 % after introduction of prompts, and 35 % after introducing education. Conclusion: Visual cues alone may be effective in increasing patient-provider communication about CAM, though low concordance between physician and nursing documentation may suggest variability in how CAM is defined and inquired about.