Pilot Deployment of ePNa Into Epic EHR

NCT ID: NCT06008314

Last Updated: 2023-09-28

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 6917 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-02-01
• Study Completion Date: 2026-06-30

Brief Summary

Intermountain Health has developed a electronic decision support tool to help doctors provide the best care for pneumonia. The purpose of this study is to enhance the existing tool (called ePneumonia (electronic Pneumonia) or ePNa) so that it can be used at other institutions, and to test deployment of the tool at another institution's hospitals.

Detailed Description

This study as funded by the AHRQ (Agency for Healthcare Research and Quality) involves making the current ePNa system a "SMART on FHIR" compatible application that will enable the same core software and processes to work across the Cerner and Epic electronic health record platforms. The investigators will then engage with emergency department providers and patients to improve user centered design, considering clinician preferences and feedback for use as well as patient needs for information. Finally, the investigators will evaluate the feasibility and acceptability via a pilot implementation trial of the interoperable ePNa platform at two Vanderbilt affiliated hospitals.

Conditions

Pneumonia

Study Design

• Allocation Method: NA
• Intervention Model: SEQUENTIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Implementation at Vanderbilt University Medical Center (VUMC) & Vanderbilt Wilson County Hospital

ePNa (the decision support tool) will be implemented at 2 EDs that are part of the Vanderbilt Health system.

Group Type: EXPERIMENTAL

ePNa

Intervention Type: OTHER

Real-time, automated clinical decision support tool for pneumonia (called "ePNa")

Interventions

ePNa

Real-time, automated clinical decision support tool for pneumonia (called "ePNa")

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

For the baseline database and assessment of clinical outcomes, all data will be pulled from the Epic Clarity data warehouse.

• 2500 patients that presented to the Vanderbilt and Wilson county EDs who are >= 18 years old will be identified by ICD-10 codes for pneumonia or acute respiratory failure or sepsis with secondary pneumonia codes for the baseline database.
• An additional 2500 patients that presented to the Vanderbilt and Wilson county EDs who are >= 18 years old will be identified by having had conventional PA (posteroanterior) and lateral or portable CXRs (chest X-rays), independent of ICD-10 codes.
• During the one year pilot trial, patients seen in the 2 EDs, who are >= 18 years old will be identified by ICD(International Classification of Diseases)-10 codes for pneumonia or acute respiratory failure or sepsis with secondary pneumonia codes (estimated to comprise 1800 patients).

Exclusion Criteria

For all above patients:

1. Patients seen with a history of recent trauma.

2. Subsequent episodes of pneumonia from the same patient within the study period.

3. Patients directly admitted to hospice/comfort care.

4. Patients admitted to a non-study hospital for further care.

5. Patients transferred from outside hospitals.

For the groups selected by ICD-10 pneumonia codes, an additional exclusion is:

• Patients without radiographic evidence of pneumonia or with clear radiographic evidence for an alternative diagnosis.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role: collaborator

Vanderbilt University

OTHER

Sponsor Role: collaborator

Stanford University

OTHER

Sponsor Role: collaborator

Nathan Dean

OTHER

Sponsor Role: lead

Responsible Party

Nathan Dean

Professor, Pulmonary and Critical Care Medicine

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Nathan Dean, MD

Role: PRINCIPAL_INVESTIGATOR

Intermountain Health

Central Contacts

Valerie Aston, MBA

Role: CONTACT

Valerie.Aston@imail.org

801-507-4606

David Tomer, MS

Role: CONTACT

David.Tomer@imail.org

801-507-4694

Other Identifiers

1052404

Identifier Type: -

Identifier Source: org_study_id