Jennifer S. Temel, M.D., of the Massachusetts General Hospital Cancer Center in Boston, and colleagues conducted a study involving 100 patients with advanced lung cancer and 100 historical controls to determine whether e-mail prompts influenced oncology physicians to document code status in the outpatient electronic health record. At the start of each new chemotherapy regimen, e-mail reminders were sent to oncologists.

The researchers found that significantly more patients with e-mail prompts had a code status documented in the outpatient electronic health record, compared with historical controls (33.6 versus 14.5 percent). The mean time for physicians to provide code status documentation was significantly shorter for those who received e-mail prompts compared with historical controls (8.6 versus 10.5 months).

"Brief e-mail prompts, timed to critical decision points in treatment and designed to encourage clinicians to discuss and document patients' resuscitation preferences in the outpatient electronic health record, improved the rate and timing of code status documentation compared with historical controls," Temel and colleagues conclude.

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