Using Information Technology To Transfer Knowledge: A Medical Institution Steps Up to the Plate

In this issue, Jain and colleagues (1) display the power of information technology (IT) to facilitate communication about important health care information. The information was Merck's withdrawal of rofecoxib at 9:00 a.m. on 30 September 2004—one of the largest drug recalls in modern history—and the power on display was the speed and specificity of electronic communications. Within 90 minutes of Merck's initial press release about the withdrawal, staff at the Cleveland Clinic Foundation began querying databases stored in their electronic medical record (EMR) to identify patients with active rofecoxib prescriptions and their providers. Within 7 hours, they deactivated prescriptions in the EMR and notified providers via e-mail. Within 22 hours, they sent letters about the withdrawal to all 11 699 patients with rofecoxib prescriptions.

We applaud the Cleveland Clinic's innovative use of their EMR to take responsibility for notifying individual patients and their physicians about a risky product. We agree that the authors' use of IT was a model that may be extended to many situations. Jain and colleagues' description of patients who had active rofecoxib prescriptions made us think about some other ways that the Cleveland Clinic might have used their EMR to transfer knowledge. We wondered whether the institution had designated faculty to routinely incorporate important information about drug safety into their state-of-the-art EMR. Had the EMR previously flagged rofecoxib prescriptions that the best available evidence indicates were unnecessary (2)? Had the EMR specifically alerted physicians writing the …