Comprehensive Clinical Decision Support (CDS) for the Primary Care of Premature Infants (PreemieCDS)
This study will use a rules-based expert system embedded in an electronic health record (EHR) to extract, interpret, and present salient facts and recommendations related to the healthcare of premature infants.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
|Official Title:||Comprehensive Clinical Decision Support (CDS) for the Primary Care of Premature Infants|
- Evaluate usability of the intervention [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]Design and evaluation of the pre-implementation data-mining and expert system will employ usability methods from the human-computer interaction (HCI) field. The methods are based on the collection of quantitative and qualitative data where each method has specific metric-based goals that are to be achieved before the next phase. 10-20 clinicians, including attending physicians, nurse practitioners and nurses, from a single practice will be recruited to participate in the Usability Study.
- Evaluate effect on care process [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]The clinical decision support (CDS) intervention will be tested for correctness and usability prior to implementation. The effect on care processes will examine process outcomes in the following domains: (1) neonatal summary documentation; (2) growth and nutrition; (3) ophthalmology; (4) hearing, speech, and language; (5) development; (6) gastro-esophageal reflux; (7) broncho-pulmonary dysplasia; and (8) apnea of prematurity. The primary evaluation will examine the change in prevalence of these process outcomes between a 12 month pre-intervention phase and a 12 month intervention phase for bo
|Study Start Date:||September 2009|
|Study Completion Date:||October 2012|
|Primary Completion Date:||October 2012 (Final data collection date for primary outcome measure)|
Active Comparator: Intervention
A clinical decision support tool for the care and management of premature infants will be embedded into the electronic health record.
Other: Clinical Decision Support Tool
A clinical decision support tool embedded within Epic will appear for children with a history of prematurity at the intervention sites.
Other Name: clinical decision support tool
No Intervention: No Intervention
No intervention, No clinical decision support tool will be used for non-intervention sites.
Premature infants are a vulnerable population with multiple inter-related health problems that put them at risk for poor outcomes. Electronic health records capture large amounts of information that may help guide decisions, but existing alert and reminder-based clinical decision support (CDS) frameworks do not adequately apply multiple overlapping care guidelines to complex patient histories to produce coherent clinical recommendations.
The primary objective of the study is to design and evaluate the usability of a CDS intervention to improve the quality of primary care for low birth weight (LBW) and very low birth weight (VLBW) premature infants from the time of intensive care nursery discharge through 24 months corrected gestational age
|United States, Pennsylvania|
|The Children's Hospital pf Philadelphia|
|Philadelphia, Pennsylvania, United States, 19104|
|Principal Investigator:||Robert Grundmeier, MD||Children's Hospital of Philadelphia|