Table 1.

Criteria for Electronic Trigger Applied to All Patient Records

Inclusion criteria

• TSH >10 mIU/L*

• Actively taking thyroid replacement therapy, defined by either:

○ New or renewed TRT medication order within prior 90 days†

○ Presence of TRT on patient’s medication list

Clinical Exclusions:

• TSH performed during or within 24 h prior to hospitalization or emergency department/urgent care visit

• Patients with medication non-adherence‡

• Patients with hyperthyroidism diagnosis

• Age <18 or >100 years

Appropriate follow-up criteria

• New TRT prescription within 30 days after TSH result

• Repeat TSH level within 60 days after TSH result

*Found using Logical Observation Identifiers Names and Codes (LOINC) codes: 3016,11579, and 11580

†TRT = thyroid replacement therapy (includes Synthroid, Levothyroxine, Lovoxyl, Armour, Thyrolar, Liotrix, Cytomel, Liothyronine Sodium, Unithroid, L-Thyroxin, Levo-T, Levoxyl, Novothyrox, Levothroid, Levolet, and Triostat)

‡Found using International Classification of Diseases, Ninth Revision (ICD-9) codes: 250.0, 250.00, 250.01, 250.02, 250.03, 250.1, 250.10, 250.11, 250.12, 250.13, 250.2, 250.20, 250.21, 250.22, 250.23, 250.3, 250.30, 250.31, 250.32, 250.33, 250.4, 250.40, 250.41, 250.42, 250.43, 250.5, 250.50, 250.51, 250.52, 250.53, 250.6, 250.60, 250.61, 250.62, 250.63, 250.7, 250.70, 250.71, 250.72, 250.73, 250.8, 250.80, 250.81, 250.82, 250.83, 250.9, 250.90, 250.91, 250.92, 250.93, 401.0, 401.1, 401.9, 405.01, 405.09, 405.11, 405.19, 405.91, 405.99, 272.1, 272.2, 272.3, 272.4, 272.5, 272.6, 272.7, 272.8, 272.9, 278.00, 278.01, 278.03, 290.13, 290.21, 296.20, 296.21, 296.22, 296.23, 296.24, 296.25, 296.26, 296.30, 296.31, 296.32, 296.33, 296.34, 296.35, 296.36, 296.82, 298.0, 301.12, 309.1, and 311