Dataset Information

Adoption of electronic medical record-based decision support for otitis media in children.

ABSTRACT:

Objective

Substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use clinical decision support (CDS) to increase guideline adherence. To inform efforts to maximize adoption, we characterized the adoption of an otitis media (OM) CDS system, the impact of performance feedback on adoption, and the effects of adoption on guideline adherence.

Study setting

A total of 41,391 OM visits with 108 clinicians at 16 pediatric practices between February 2009 and August 2010.

Study design

Prospective cohort study of EHR-based CDS adoption during OM visits, comparing clinicians receiving performance feedback to none. CDS was available to all physicians; use was voluntary.

Data collection

Extraction from a common EHR.

Principal findings

Clinicians and practices used the CDS system for a mean of 21 percent (range: 0-85 percent) and 17 percent (0-51 percent) of eligible OM visits, respectively. Clinicians who received performance feedback reports summarizing CDS use and guideline adherence had a relative increase in CDS use of 9.0 percentage points compared to others (p = .001). CDS adoption was associated with increased OM guideline adherence. Effects were greatest among clinicians with the lowest adherence prior to the study.

Conclusions

Performance feedback increased CDS adoption, but additional strategies are needed to integrate CDS into primary care workflows.

SUBMITTER: Fiks AG

PROVIDER: S-EPMC4369219 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Publications

Adoption of electronic medical record-based decision support for otitis media in children.

Fiks Alexander G AG Zhang Peixin P Localio A Russell AR Khan Saira S Grundmeier Robert W RW Karavite Dean J DJ Bailey Charles C Alessandrini Evaline A EA Forrest Christopher B CB

Health services research 20141006 2

<h4>Objective</h4>Substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use clinical decision support (CDS) to increase guideline adherence. To inform efforts to maximize adoption, we characterized the adoption of an otitis media (OM) CDS system, the impact of performance feedback on adoption, and the effects of adoption on guideline adherence.<h4>Study setting</h4>A total of 41,391 OM visits with 108 clinicians at 16 pediatric practices between ...[more]

PMID: 25287670

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Dataset Information

Adoption of electronic medical record-based decision support for otitis media in children.

Objective

Study setting

Study design

Data collection

Principal findings

Conclusions

Publications

Adoption of electronic medical record-based decision support for otitis media in children.

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