Improving Otitis Media Care With Clinical Decision Support
Condition: Otitis Media
MeSH terms: Otitis; Otitis Media
Study type: Interventional
Phase: Phase 3

Summary: 
      This protocol will prospectively develop a new electronic health record (EHR)-based health
      information technology (IT) intervention that a) summarizes Otitis Media (OM) care into
      clinically meaningful episodes-of-care, b) provides clinical decision support based upon
      evidence-based guidelines to primary care and ENT physicians working within an integrated
      physician network that uses a common EHR, and c) tests the additive effects on quality and
      resource utilization of providing feedback to physicians.
    

Detailed description: 
      Context The high prevalence of Otitis Media (OM) and its enormous cost make it a prime target
      for cost-effective and evidence-based strategies for disease management.

      Objectives

      This protocol will prospectively develop a new electronic health record (EHR)-based health
      information technology (IT) intervention that a) summarizes OM care into clinically
      meaningful episodes-of-care, b) provides clinical decision support based upon evidence-based
      guidelines to primary care and ENT physicians working within an integrated physician network
      that uses a common EHR, and c) tests the additive effects on quality and resource utilization
      of providing feedback to physicians. The specific aims are:

      Aim 1: To develop and pilot test the OM health IT intervention; Aim 2: To examine the overall
      effect of the health IT intervention and the independent contribution of physician feedback
      on quality of OM care (primary outcomes); Aim 3: To assess the effects of the intervention on
      the secondary outcomes of health care resource utilization and clinician adoption of the
      health IT.

      Study Design/Settings/Participants A cluster randomized trial and multi-level statistical
      modeling will be used to estimate health IT intervention effects on study outcomes. The
      proposed project will be conducted in the Children's Hospital of Philadelphia's (CHOP) health
      care system. The heath IT intervention will be tested in the Pediatric Research Consortium
      (PeRC), which includes 28 primary care practices in the CHOP network, both urban and
      suburban, and the CHOP ENT clinical sites. Randomization and implementation of the
      intervention will occur at the practice level. Study outcomes of quality of care and resource
      utilization will be reported at the levels of the practice, individual practitioner, and
      episode-of-care (patient-level).

      Study Measures Our main study measures include the quality of otitis media care provided
      during episodes of OM.

      Our secondary outcomes include measurement of clinician adoption of the health IT
      intervention and resource use.
    

Intervention name(s): 3-Part Intervention; 4-Part Intervention; 1-part intervention
Intervention type(s): Other; Other; Other
Intervention description(s): A combination of training, an otitis media episode grouper, and clinical decision support.; A combination of clinician training, an otitis media episode grouper, clinical decision support, and feedback.; Provision of feedback on otitis media quality indicators
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Electronic Health Record; Clinical Decision Support; Otitis Media