Child Health Improvement Through Computer Automation (CHICA) Highlighting Study

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Aaron Carroll, Indiana University
ClinicalTrials.gov Identifier:
NCT01583101
First received: April 18, 2012
Last updated: November 13, 2012
Last verified: November 2012
  Purpose

The investigators have developed a novel decision support system for implementing clinical guidelines in pediatric practice. CHICA (Child Health Improvement through Computer Automation) combines three elements: (1) pediatric guidelines encoded in Arden Syntax; (2) a dynamic, scannable paper user interface; and (3) an HL7-compliant interface to existing electronic medical record systems. The result is a system that both delivers "just-in-time" patient-relevant guidelines to physicians during the clinical encounter, and accurately captures structured data from all who interact with it. Preliminary work with CHICA has demonstrated the feasibility of using the system to implement and evaluate clinical guidelines.

However, analyses have shown that physicians ignore a fair number of prompts. The investigators would like to experiment with changes to the system to see if they can increase physicians' response rates. This could include highlighting prompts, reordering them, or flagging them in other ways. The main outcome of interest in the rate at which physicians answer prompts.


Condition Intervention
Physician Behavior
Other: Highlight set 1
Other: Highlight Set 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Increasing Prompt Response Rates in the CHICA System

Further study details as provided by Indiana University:

Primary Outcome Measures:
  • Increased prompt response [ Time Frame: 1 year ] [ Designated as safety issue: No ]
    The main outcome of interest is whether or not a prompt was answered (discussed/not discussed).


Enrollment: 2237
Study Start Date: April 2012
Study Completion Date: October 2012
Primary Completion Date: October 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Highlighting Set 1
We will randomize two prompts to be highlighted to see if it increases response rate.
Other: Highlight set 1
We will highlight two prompts.
Experimental: Highlighting Set 2
We will highlight two different prompts to see if response rate increases.
Other: Highlight Set 2
We will highlight 2 different prompts

Detailed Description:

We have developed a novel decision support system for implementing clinical guidelines in pediatric practice. CHICA (Child Health Improvement through Computer Automation) combines three elements: (1) pediatric guidelines encoded in Arden Syntax; (2) a dynamic, scannable paper user interface; and (3) an HL7-compliant interface to existing electronic medical record systems. The result is a system that both delivers "just-in-time" patient-relevant guidelines to physicians during the clinical encounter, and accurately captures structured data from all who interact with it. Preliminary work with CHICA has demonstrated the feasibility of using the system to implement and evaluate clinical guidelines.

However, analyses have shown that physicians ignore a fair number of prompts. We would like to experiment with changes to the system to see if we can increase physicians' response rates. This could include highlighting prompts, reordering them, or flagging them in other ways. The main outcome of interest is the rate at which physicians answer prompts.

This will be a randomized, controlled trial of the CHICA system to see if we can improve prompt response rates. We will randomize physicians or clinics to receive some form of prompt change, including highlighting them, reordering them, or flagging them. No other changes will be made to care.

We will extract data from the CHICA system for all patients seen in our study clinics. This data will include a the clinic location, whether or not a physician responded to a prompt, the prompt's position on the form, the patient's gender, the rule priority of the prompt, rule title, patient insurance category, the patient's age in days, and the name of the provider. The main outcome of interest is whether or not a prompt was answered (discussed/not discussed).

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Physicians practicing in one of our four CHICA clinics who use CHICA

Exclusion Criteria:

  • Not being a physician practicing in one of our four CHICA clinics who use CHICA
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01583101

Locations
United States, Indiana
IUMG Clinic System
Indianapolis, Indiana, United States, 46202
Sponsors and Collaborators
Indiana University
  More Information

No publications provided

Responsible Party: Aaron Carroll, Assoc. Prof of Pediatrics, Indiana University
ClinicalTrials.gov Identifier: NCT01583101     History of Changes
Other Study ID Numbers: CHICA_Highlight_Study
Study First Received: April 18, 2012
Last Updated: November 13, 2012
Health Authority: United States: Institutional Review Board

ClinicalTrials.gov processed this record on August 18, 2014