Electronic Health Record (EHR) Decision Support to Improve Outpatient Asthma Care

Children's Hospital of Philadelphia (CHOP)

Status: Completed

Conditions: Asthma

Treatments: Other: Intervention; Other: Control

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT00918944

2005-11-4596

Details and patient eligibility

About

To determine whether an innovative clinical decision support system embedded in an existing electronic health record (EHR) will improve provider adherence to the existing National Asthma Education and Prevention Program (NAEPP) guidelines.

12 primary care pediatric practices at The Children's Hospital of Philadelphia(both urban and suburban sites) will be randomized to receive either a passive EHR (control sites) or an interactive decision support system (intervention sites).

Full description

After receiving a standardized education module based on NAEPP guidelines, 12 primary care pediatric practices (both urban and suburban sites) will be randomized to receive either a passive EHR (control sites) or an interactive decision support system (intervention sites).

The primary outcome of interest will be the proportion of patients on appropriate asthma controller medication compared over time. Secondary outcomes include the proportion of asthma patients with: 1) an updated asthma action plan 2) documentation of spirometry performed (6 to 17 yrs) and 3) an updated problem list reflecting current asthma severity. After hours calls to providers and types of office visits related to asthma will be tracked. 4) In addition, measurement of asthma-related quality of life and missed school and work in a sample of 200 subjects from each group will be performed. Contextual factors at the clinic and patient level will be examined to assess their association with outcomes of interest.

If shown to be successful, this type of clinical decision support, embedded within the EHR, has the potential to be a powerful tool to improve the implementation of asthma guidelines and clinical practice guidelines for other conditions and illnesses in the primary setting.

Enrollment: 12 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• Known patients with asthma

Exclusion criteria

• None

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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12 participants in 2 patient groups

Control arm

Other group

Description:

Practices with the EHR implemented will be randomized have the asthma disease management tools available passively (the control group).

Treatment:

Other: Control

Intervention arm

Other group

Description:

The intervention sites will have decision support alerts and reminders activated to guide providers toward these tools in the appropriate situations.

Treatment:

Other: Intervention