Impact of electronic medical record embedded LLM
Conditions
Interventions
Usual Care i.e. Clinicians without LLM Clinical Decision Support System
LLM Clinical Decision Support System
Sponsors
PATH
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Inclusion Criteria for CLINICIANS: ? Clinicians qualified and registered with the Clinical Officers Council in Kenya ? Clinicians with 3 months prior practice at Penda facility at time of enrollment. ? Willing and able to use the Penda electronic health record for all consultations during study period. ? Willing to consent for their participation in the study and is able to undergo training to adhere to study protocol during consultations. Inclusion Criteria for PATIENT PARTICIPANTS: ? Willing and able to adhere to study requirements, including attendance of follow up consultations. ? Willing to consent for their participation in the study.
Exclusion criteria
Exclusion criteria: Exclusion Criteria for CLINICIANS: ? None. Exclusion Criteria for PATIENT PARTICIPANTS ? Adult patients attending for non-acute/planned wellness visits (for example, weight checks, vaccinations, routine antenatal care). *Paediatric patients attending for any reason are eligible for participation. ? Unable or unwilling to be contacted by phone. ? Adults not of sound mind ? Minors aged 12 years and above who have declined assent and whose caregivers have declined consent for participation in the study. ? Unable or unwilling to be contacted by study staff to collect follow-up outcome data. ? Patients known to be requiring immediate or emergency care.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Composite measure of treatment failure, indicated by the occurrence of any of the following within 14 days: I.Re-presentation to Primary Care: Any return visit to a primary care provider (e.g., Penda facility, over-the-counter pharmacy, another primary care facility) with ongoing or unresolved symptoms reported during the first visit. II.Escalation of Care: Any unplanned visit to a secondary care or emergency care provider for an issue related to the initial (primary care) presenting complaint. III.Safety/Adverse Events: Any safety event linked to the initial presentation | — |
Secondary
| Measure | Time frame |
|---|---|
| Safety and appropriateness of LLM-assisted consultations;Effectiveness of the LLM CDSS in the diagnosis and treatment of sentinel conditions (hypertension, type 2 diabetes mellitus, and malnutrition in children under 5 years).;Effectiveness of the LLM CDSS on reducing inappropriate antibiotic and antimalarial prescriptions;Patient satisfaction with consultations based on perceptions of consultation thoroughness, clarity, and overall satisfaction. | — |
Countries
Kenya
Contacts
Public ContactBilal;Bilal Mateen;Mateen
PATH;PATH
Outcome results
None listed