Child Health Improvement Through Computer Automation - Child Neurology (CHICA-CN) Evaluation

Wake Forest University (WFU)

Status: Completed

Conditions: Neurologic Disorder

Treatments: Other: Computer decision support for physician

Study type: Observational

Funder types: Other

Identifiers

NCT05173506

IRB00078610

Details and patient eligibility

About

The study will evaluate a computer decision support system for child neurology, Child Health Improvement through Computer Automation - Child Neurology (CHICA-CN) using patient chart review, family phone surveys, and physician interviews in a before-after study design.

Full description

(CHICA-CN) Child Health Improvement through Computer Automation - Child Neurology is software that works with the electronic health record (EHR) to improve the efficiency and quality of care in the outpatient setting. Built in partnership with the Child Neurology Foundation, CHICA's guidance is based on authoritative guidelines from the American Academy of Neurology and others. The plan is to implement CHICA-CN in the Child Neurology Clinics at Wake Forest Baptist Health. To evaluate CHICA-CN the proposal is to look at data derived from three sources:

1. Chart Review to evaluate quality of care based on measures derived from four algorithms developed from American Academy of Neurology quality measures and typically documented in the medical record. This will be a before-after study design in which measurements will be obtained before and after the installation of CHICA-CN.
2. Parent Phone Surveys to Document the parent experience in terms of physician-patient communication, parent engagement, and satisfaction with use of the patient facing tablet interface. These data will be collected from families of patients identified for the chart review after the intervention.
3. Physician user satisfaction measures, including perceived value of the system and ease of use in general and as regards individual clinical issues. Surveys will be administered to physicians and clinic staff who used CHICA-CN.

Enrollment: 455 patients

Sex: All

Ages: Under 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Must be patients in the participating clinical practices meeting inclusion criteria for one of the four cohorts

Exclusion criteria

• N/A

Trial design

455 participants in 4 patient groups

Adolescent Depression Screening

Description:

* \> 3 visits to clinic * Diagnosis of epilepsy - International Classification of Diseases, Tenth Revision - Epilepsy and recurrent seizures (ICD-10:G40) * Age \> 12 years at last visit (before CHICA-CN) Computer assistant depression screening and management

Treatment:

Other: Computer decision support for physician

Genetic Testing

Description:

* \> 3 visits to clinic * Diagnosis of global developmental delay - International Classification of Diseases, Tenth Revision - autistic disorder (ICD-10: F84) * Age \< 6 years at last visit (before CHICA-CN) Computer reminders to test for genetic disorders

Treatment:

Other: Computer decision support for physician

Rescue seizure therapy

Description:

* \> 3 visits to clinic * Diagnosis of epilepsy - International Classification of Diseases, Tenth Revision - Epilepsy and recurrent seizures (ICD-10: G40) * Age \< 18 years at last visit (before CHICA-CN) Computer reminders to prescribe and adjust rescue anti-seizure medications

Treatment:

Other: Computer decision support for physician

Adolescent Transition

Description:

* \> 3 visits to clinic * Age \> 13 years at last visit (before CHICA-CN) Computer supported screening and counseling regarding transition to adult care

Treatment:

Other: Computer decision support for physician