Study of an Intervention to Improve Problem List Accuracy and Use

NCT ID: NCT01105923

Last Updated: 2015-02-02

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 140 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-05-31
• Study Completion Date: 2017-11-30

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.

Conditions

Attention Deficit Disorder With Hyperactivity; Asthma; COPD; Breast Cancer; Coronary Artery Disease; Congestive Heart Failure; Diabetes; Glaucoma; Hemophilia; Hypertension; Hyperthyroidism; Hypothyroidism; Myasthenia Gravis; Osteoporosis; Osteopenia; Renal Failure; Renal Insufficiency; Sickle Cell Disease; Stroke

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: DIAGNOSTIC
• Blinding Strategy: NONE

Study Groups

Receive CDS intervention

Providers in clinics that will receive the CDS alert, as their clinic was randomized into our study.

Group Type: EXPERIMENTAL

MAPLE

Intervention Type: OTHER

MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them.

No CDS intervention

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

MAPLE

MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Independent healthcare provider (physician, NP, PA)
• Practices at participating site

Exclusion Criteria

• None

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Brigham and Women's Hospital

OTHER

Sponsor Role: lead

Responsible Party

Adam Wright

Senior Scientist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Adam Wright, PhD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

Brigham and Women's Hospital

Boston, Massachusetts, United States

Countries

United States

References

Wright A, Pang J, Feblowitz JC, Maloney FL, Wilcox AR, McLoughlin KS, Ramelson H, Schneider L, Bates DW. Improving completeness of electronic problem lists through clinical decision support: a randomized, controlled trial. J Am Med Inform Assoc. 2012 Jul-Aug;19(4):555-61. doi: 10.1136/amiajnl-2011-000521. Epub 2012 Jan 3.

Reference Type: DERIVED

PMID: 22215056 (View on PubMed)

Other Identifiers

2009P001846

Identifier Type: -

Identifier Source: org_study_id