An Implementation Model for Clinical Decision Support for Heart Failure Prescribing

University of Colorado Denver (CU Denver)

Status: Completed

Conditions: Decision Support Systems, Clinical; Heart Failure

Treatments: Other: Decision Support Systems, Clinical

Study type: Interventional

Funder types: Other

Identifiers

NCT04028557

19-0020

Details and patient eligibility

About

The objective of this proposal is to compare clinical outcomes, implementation metrics (i.e., patient reach and clinician adoption), and clinician preferences of two designs (customized vs. commercial) of a clinical decision support (CDS). Beta blocker prescribing for patients with heart failure will be used as a test case. The best practices in CDS design, including the user-centered design will be incorporated into the customized CDS and compared to a commercially-available CDS in the electronic health record using a cluster randomized trial.

Enrollment: 118 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Study subjects are providers

Inclusion Criteria:

• Prescribing primary care clinicians at University of Colorado Health (UCHealth) who provide care for patients with heart failure and reduced ejection fraction

Exclusion Criteria:

• None

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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118 participants in 2 patient groups

Customized CDS

Experimental group

Description:

The customized CDS will be designed and implemented with comprehensive application of known best practice principles in CDS design. The recommendation will be to initiate an evidence-based beta blocker for heart failure.

Treatment:

Other: Decision Support Systems, Clinical

Commercial CDS

Active Comparator group

Description:

The commercial CDS is available to all institutions using the Epic electronic health record vendor, but violates some CDS design best practices, notably not being tailored to the end users of a given health system. The recommendation will be to initiate an evidence-based beta blocker for heart failure.

Treatment:

Other: Decision Support Systems, Clinical