Clinical trial NCT01105923: Study of an Intervention to Improve Problem List Accuracy and Use
Official title: Making Accurate Problem Lists in the EHR
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
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
Lead sponsor: Brigham and Women's Hospital
Sponsor class: OTHER
First posted: 2010-04-19
Enrollment: 140
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: DIAGNOSTIC

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.

Eligibility criteria: Inclusion Criteria:

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

Exclusion Criteria:

* None

Primary outcomes:
measure: Intervention acceptance
timeFrame: 6 months (May 2010-Nov2010)
Secondary outcomes:
measure: Problem list prevalence
timeFrame: pre and post intervention
measure: Problem list incidence
timeFrame: pre and post intervention
measure: Quality improvement based on problem list accuracy/completion
timeFrame: post intervention
Other outcomes:
Locations:
city: Boston
country: United States
facility: Brigham and Women's Hospital
state: Massachusetts
Study officials:
affiliation: Brigham and Women's Hospital
name: Adam Wright, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.