Computerized Decision Support System Linked to Electronic Health Records to Improve Patient Care in a General Hospital

Study Overview
=================
Brief Summary
-----------------
Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge.

Detailed Description
-----------------
The investigators designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, point-of-care reminders on clinical practice and the quality of care. The investigators hypothesize that these reminders can increase clinician adherence to guidelines and, eventually, improve the quality of care offered to hospitalized patients. The results of the investigators study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings.

Official Title
-----------------
Implementing an Evidence-based Computerized Decision Support System Linked to Electronic Health Records to Improve Patient Care in a General Hospital

Conditions
-----------------
Physician's Role

Intervention / Treatment
-----------------
* Other: Medilogy Decision Support System (MediDSS)


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: All of the patients admitted into the internal medicine departments of the Azienda Ospedaliera di Desio e Vimercate during the study period. Exclusion Criteria: None
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Electronic Health Records with computerised decision support system activated Medilogy Decision Support System (MediDSS) | Other: Medilogy Decision Support System (MediDSS)<br>* Italian translation of Evidence-Based Medicine electronic Decision Support (EBMeDS), a set of rules (scripts) based on Evidence Based Medicine guidelines and applied to structured health data. MediDSS further includes knowledge from Swedish, Finnish, INteraction X-referencing (SFINX), a drug-drug interaction database containing concise evidence-based information of about 18,000 drug interactions and adverse events. MediDSS is integrated with local reminders.<br>|
| Other: Control<br>Electronic Health Records with computerised decision support system silenced Medilogy Decision Support System (MediDSS) silenced | Other: Medilogy Decision Support System (MediDSS)<br>* Italian translation of Evidence-Based Medicine electronic Decision Support (EBMeDS), a set of rules (scripts) based on Evidence Based Medicine guidelines and applied to structured health data. MediDSS further includes knowledge from Swedish, Finnish, INteraction X-referencing (SFINX), a drug-drug interaction database containing concise evidence-based information of about 18,000 drug interactions and adverse events. MediDSS is integrated with local reminders.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resolution rates | Rate at which the medical problems, which are detected by the MediDSS software and reported through the reminders, are resolved (resolution rates). | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| in-hospital mortality |  | 12 months | 
| length of hospital stay |  | 12 months |