# Improving Folic Acid Supplementation Through Electronic Medical Record Interface Modifications—A Retrospective Study

## TL;DR

Modifying electronic medical record interfaces increased folic acid testing and supplement use among women of reproductive age, improving preventive care.

## Contribution

Demonstrates that digital interface changes in medical records can effectively boost preventive health behaviors.

## Key findings

- Testing rates increased from 14.74% to 17.35% after interface modifications.
- Deficiency detection improved from 6.30% to 7.38% post-intervention.
- Supplement consumption tripled from 5.45% to 15.98%, with most users being new.

## Abstract

Background: Folic acid is essential for DNA synthesis and fetal development, with deficiency linked to anemia, cardiovascular disease and pregnancy complications. The clinical guidelines for women of reproductive age mandate supplementation as a universal preventive treatment regardless of blood folic acid levels; therefore, routine folic acid level testing is not recommended for this population. However, the vast majority of pregnant women do not implement the recommended preventive actions, indicating that new strategies are needed to improve that situation. Objectives: This study examined the impact of modifying the laboratory test-ordering interface in the medical record system, designed to simplify the ordering of folic acid level tests, on testing rates, deficiency detection and supplement consumption among women of reproductive age. Methods: This retrospective cohort analysis compared outcomes reflecting the impact of the modification on 43,952 women aged 18–42 years, assessed over one year pre- and post-integration. Statistical analyses included Chi-squared tests and logistic regression, with adjustments for age and socio-geographic status. Results: Post-intervention, testing rates increased from 14.74% to 17.35% (p < 0.0001), and deficiency detection rose from 6.30% to 7.38% (p < 0.0001). Supplement consumption tripled from 5.45% to 15.98% (p < 0.0001), with 91.37% of post-intervention consumers being new users. Conclusions: Modifying the presentation of tests in the laboratory test-ordering interface within electronic medical records significantly improved testing rates, enhanced deficiency detection and had a meaningful impact on treatment outcomes. These findings underscore the potential of system-level digital interventions to advance preventive care and overall health. Future research should focus on examining scalability, implementation and long-term outcomes across diverse healthcare settings.