Asthma, Attention Deficit Disorder With Hyperactivity, Breast Cancer, Congestive Heart Failure, COPD, Coronary Artery Disease, Diabetes, Glaucoma, Hemophilia, Hypertension, Hyperthyroidism, Hypothyroidism, Myasthenia Gravis, Osteopenia, Osteoporosis, Renal Failure, Renal Insufficiency, Sickle Cell Disease, Stroke
Conditions
Brief summary
The aim of this study is to identify patients with problem list gaps and intervene to correct these gaps by creating clinical decision support interventions that alert providers to likely problem list gaps and offer clinicians the opportunity to correct them. The investigators will randomize the clinics that will receive the intervention and formally evaluate the study after a period of 6 months for improved problem list completeness to determine the effectiveness of our intervention.
Detailed description
The clinical problem list is a cornerstone of the problem-oriented medical record. Problem lists are used in a variety of ways throughout the process of clinical care. In addition to its use by clinicians, the problem list is also critical for decision support and quality measurement. Patients with gaps in their problem list face significant risks. For example, if a hypothetical patient has diabetes properly documented, his clinician would receive appropriate alerts and reminders to guide care. Additionally, the patient might be included in special care management programs and the quality of care provided to him would be measured and tracked. Without diabetes on his problem list, he might receive none of these benefits. In this study, the investigators developed an clinical decision support intervention that will identify patients with problem lists gaps. The investigators will alert providers of these likely gaps and offer providers the opportunity to correct them.
Interventions
OTHERMAPLE
MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them.
Sponsors
Brigham and Women's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Independent healthcare provider (physician, NP, PA) * Practices at participating site
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intervention acceptance | 6 months (May 2010-Nov2010) | Of those providers who were shown (or who would have been shown, for the control group) the intervention, the number that added a problem across control and intervention groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Problem list prevalence | pre and post intervention | Number of patients with selected problems on their problem list pre and post intervention across intervention and control groups. |
| Problem list incidence | pre and post intervention | For the conditions of interest, the percent of patients that had the problem added during the study period |
| Quality improvement based on problem list accuracy/completion | post intervention | For those with problems added due to the intervention, the number of new triggered reminders or other clinical actions. |
Countries
United States
Outcome results
None listed