Electronic Health Record (EHR) Decision Support to Improve Outpatient Asthma Care
NCT ID: NCT00918944
Last Updated: 2011-12-23
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
12 participants
INTERVENTIONAL
2006-01-31
2009-08-31
Brief Summary
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12 primary care pediatric practices at The Children's Hospital of Philadelphia(both urban and suburban sites) will be randomized to receive either a passive EHR (control sites) or an interactive decision support system (intervention sites).
Detailed Description
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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. 4) 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. Contextual factors at the clinic and patient level will be examined to assess their association with outcomes of interest.
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 in the primary setting.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Control arm
Practices with the EHR implemented will be randomized have the asthma disease management tools available passively (the control group).
Control
The asthma disease management toolkit available to all practices in the EHR will consist of four elements:
* A data entry tool for capturing asthma control data
* Standardized documentation templates to facilitate severity classification
* Order sets to facilitate ordering controller medications
* An asthma care plan that can be supplied to families
Intervention arm
The intervention sites will have decision support alerts and reminders activated to guide providers toward these tools in the appropriate situations.
Intervention
Three alerts and two reminders will be programmed:
* Alert providers to enter asthma severity classification if none is on file
* Alert providers to prescribe controller medications for persistent asthma if none on file
* Alert providers to complete an asthma care plan if none on file
* Remind providers to review the asthma care plan if it is already on file by providing a link to the form
* Remind providers that educational content is available on-line by providing a web link
Interventions
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Control
The asthma disease management toolkit available to all practices in the EHR will consist of four elements:
* A data entry tool for capturing asthma control data
* Standardized documentation templates to facilitate severity classification
* Order sets to facilitate ordering controller medications
* An asthma care plan that can be supplied to families
Intervention
Three alerts and two reminders will be programmed:
* Alert providers to enter asthma severity classification if none is on file
* Alert providers to prescribe controller medications for persistent asthma if none on file
* Alert providers to complete an asthma care plan if none on file
* Remind providers to review the asthma care plan if it is already on file by providing a link to the form
* Remind providers that educational content is available on-line by providing a web link
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
ALL
No
Sponsors
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Agency for Healthcare Research and Quality (AHRQ)
FED
Children's Hospital of Philadelphia
OTHER
Responsible Party
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Principal Investigators
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Louis M Bell, MD
Role: PRINCIPAL_INVESTIGATOR
Children's Hospital of Philadelphia
Locations
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The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Countries
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Other Identifiers
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2005-11-4596
Identifier Type: -
Identifier Source: org_study_id