EHR Decision Support to Improve Outpatient Asthma Care

EHR 决策支持改善门诊哮喘护理

• 批准号: 7008379
• 负责人: LOUIS M BELL
• 金额: $ 24.85万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-01-02 至 2007-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7008379
• 关键词: asthma; automated medical record system; behavioral /social science research tag; clinical research; computer assisted medical decision making; computer assisted patient care; education evaluation /planning; health care personnel education; health care personnel performance; health care service evaluation; health services research tag; human subject; outcomes research; patient care management; pediatrics

DESCRIPTION (provided by applicant): Background: National Asthma Education and Prevention Program (NAEPP) guidelines exist, but are underused in primary care. In addition, implementation of guidelines has been shown to vary according to location of practice and other contextual factors. Objective: The Children's Hospital of Philadelphia Pediatric Research Consortium (PeRC), a practice-based research network will determine whether an innovative clinical decision support system embedded in an existing electronic health record (EHR) will improve provider adherence to the existing NAEPP guidelines. Methods: After receiving a standardized education module based on NAEPP guidelines, 10 primary care pediatric practices (both urban and suburban sites) will be randomized to receive either a passive EHR (control sites) or an interactive decision support system (intervention sites). The primary outcome of interest will be the proportion of patients on appropriate asthma controller medication compared over time. Secondary outcomes include the proportion of asthma patients with: 1) an updated asthma action plan, 2) documentation of spirometry performed (6 to 17 yrs.) and 3) an updated problem list reflecting current asthma severity. After hours calls to providers and types of office visits related to asthma will be tracked. Contextual factors at the clinic and patient level will be examined to assess their association with outcomes of interest. In addition, measurement of asthma-related quality of life and missed school and work in a sample of 200 subjects from each group will be performed. If shown to be successful, this type of clinical decision support, embedded within the EHR, has the potential to be a powerful tool to improve the implementation of asthma guidelines and clinical practice guidelines for other conditions and illnesses.

描述（由申请人提供）： 背景：国家哮喘教育和预防计划 (NAEPP) 指南已有，但在初级保健中未得到充分利用。此外，事实证明，指南的实施会根据实践地点和其他背景因素而有所不同。目标：费城儿童医院儿科研究联盟 (PeRC) 是一个基于实践的研究网络，将确定嵌入现有电子健康记录 (EHR) 的创新临床决策支持系统是否会提高提供者对现有 NAEPP 指南的遵守程度。 方法：在接受基于 NAEPP 指南的标准化教育模块后，10 个初级保健儿科诊所（城市和郊区站点）将被随机分配接受被动 EHR（控制站点）或交互式决策支持系统（干预站点）。 感兴趣的主要结果是随着时间的推移，服用适当哮喘控制药物的患者比例。次要结局包括具有以下特征的哮喘患者比例：1) 更新的哮喘行动计划，2) 进行的肺活量测定记录（6 至 17 岁），以及 3) 反映当前哮喘严重程度的更新的问题列表。下班后致电提供者的电话以及与哮喘相关的办公室就诊类型将被跟踪。将检查诊所和患者层面的背景因素，以评估它们与感兴趣的结果的关联。此外，还将对每组 200 名受试者进行样本测量，测量与哮喘相关的生活质量以及旷课和旷工情况。如果被证明是成功的，这种嵌入 EHR 中的临床决策支持有可能成为改进哮喘指南和其他病症和疾病的临床实践指南实施的强大工具。