Electronic health record-based decision support to improve asthma care: a cluster-randomized trial.
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| Title: | Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. |
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| Authors: | Bell LM (AUTHOR), Grundmeier R (AUTHOR), Localio R (AUTHOR), Zorc J (AUTHOR), Fiks AG (AUTHOR), Zhang X (AUTHOR), Stephens TB (AUTHOR), Swietlik M (AUTHOR), Guevara JP (AUTHOR) |
| Source: | Pediatrics. Apr2010, Vol. 125 Issue 4, pe770-7. 1p. |
| Abstract: | OBJECTIVE: Asthma continues to be 1 of the most common chronic diseases of childhood and affects approximately 6 million US children. Although National Asthma Education Prevention Program guidelines exist and are widely accepted, previous studies have demonstrated poor clinician adherence across a variety of populations. We sought to determine if clinical decision support (CDS) embedded in an electronic health record (EHR) would improve clinician adherence to national asthma guidelines in the primary care setting. METHODS: We conducted a prospective cluster-randomized trial in 12 primary care sites over a 1-year period. Practices were stratified for analysis according to whether the site was urban or suburban. Children aged 0 to 18 years with persistent asthma were identified by International Classification of Diseases, Ninth Revision codes for asthma. The 6 intervention-practice sites had CDS alerts imbedded in the EHR. Outcomes of interest were the proportion of children with at least 1 prescription for controller medication, an up-to-date asthma care plan, and the performance of office-based spirometry. RESULTS: Increases in the number of prescriptions for controller medications, over time, was 6% greater (P = .006) and 3% greater for spirometry (P = .04) in the intervention urban practices. Filing an up-to-date asthma care plan improved 14% (P = .03) and spirometry improved 6% (P = .003) in the suburban practices with the intervention. CONCLUSION: In our study, using a cluster-randomized trial design, CDS in the EHR, at the point of care, improved clinician compliance with National Asthma Education Prevention Program guidelines. [ABSTRACT FROM AUTHOR] |
| Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 105165946 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Bell+LM%22">Bell LM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Grundmeier+R%22">Grundmeier R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Localio+R%22">Localio R</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zorc+J%22">Zorc J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fiks+AG%22">Fiks AG</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zhang+X%22">Zhang X</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stephens+TB%22">Stephens TB</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Swietlik+M%22">Swietlik M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Guevara+JP%22">Guevara JP</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Pediatrics%22">Pediatrics</searchLink>. Apr2010, Vol. 125 Issue 4, pe770-7. 1p. – Name: Abstract Label: Abstract Group: Ab Data: OBJECTIVE: Asthma continues to be 1 of the most common chronic diseases of childhood and affects approximately 6 million US children. Although National Asthma Education Prevention Program guidelines exist and are widely accepted, previous studies have demonstrated poor clinician adherence across a variety of populations. We sought to determine if clinical decision support (CDS) embedded in an electronic health record (EHR) would improve clinician adherence to national asthma guidelines in the primary care setting. METHODS: We conducted a prospective cluster-randomized trial in 12 primary care sites over a 1-year period. Practices were stratified for analysis according to whether the site was urban or suburban. Children aged 0 to 18 years with persistent asthma were identified by International Classification of Diseases, Ninth Revision codes for asthma. The 6 intervention-practice sites had CDS alerts imbedded in the EHR. Outcomes of interest were the proportion of children with at least 1 prescription for controller medication, an up-to-date asthma care plan, and the performance of office-based spirometry. RESULTS: Increases in the number of prescriptions for controller medications, over time, was 6% greater (P = .006) and 3% greater for spirometry (P = .04) in the intervention urban practices. Filing an up-to-date asthma care plan improved 14% (P = .03) and spirometry improved 6% (P = .003) in the suburban practices with the intervention. CONCLUSION: In our study, using a cluster-randomized trial design, CDS in the EHR, at the point of care, improved clinician compliance with National Asthma Education Prevention Program guidelines. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Pediatrics is the property of American Academy of Pediatrics and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1542/peds.2009-1385 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 1 StartPage: e770 Titles: – TitleFull: Electronic health record-based decision support to improve asthma care: a cluster-randomized trial. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Bell LM – PersonEntity: Name: NameFull: Grundmeier R – PersonEntity: Name: NameFull: Localio R – PersonEntity: Name: NameFull: Zorc J – PersonEntity: Name: NameFull: Fiks AG – PersonEntity: Name: NameFull: Zhang X – PersonEntity: Name: NameFull: Stephens TB – PersonEntity: Name: NameFull: Swietlik M – PersonEntity: Name: NameFull: Guevara JP IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 04 Text: Apr2010 Type: published Y: 2010 Identifiers: – Type: issn-print Value: 00314005 Numbering: – Type: volume Value: 125 – Type: issue Value: 4 Titles: – TitleFull: Pediatrics Type: main |
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