Improving Quality With Outpatient Decision Support - Full Text View

Sponsor:	Agency for Healthcare Research and Quality (AHRQ)
Information provided by:	Agency for Healthcare Research and Quality (AHRQ)
ClinicalTrials.gov Identifier:	NCT00225628

Purpose

Assesses physician compliance with paper-based and electronic guidelines, reminders, and alerts for outpatient settings. Target areas for the reminders and alerts are disease management, medication management, and interpretation of abnormal test results.

Condition	Intervention
Diabetes Mellitus Coronary Artery Disease Osteoporosis Hypertension Hyperlipidemia	Behavioral: Computerized Reminders Medications Monitoring Behavioral: Computerized Test Results Management Application Behavioral: Computerized Reminders Hypertension Management Behavioral: Computerized Reminders Osteoporosis Screening and Mgt

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention
Official Title:	Improving Quality With Outpatient Decision Support

Resource links provided by NLM:

Genetics Home Reference related topics: 6q24-related transient neonatal diabetes mellitus

MedlinePlus related topics: Coronary Artery Disease High Blood Pressure Osteoporosis

U.S. FDA Resources

Further study details as provided by Agency for Healthcare Research and Quality (AHRQ):

Primary Outcome Measures:

1) Compliance to guidelines regarding the outpatient laboratory monitoring of prescription medication regiments
2) Compliance to guidelines regarding the follow-up of abnormal test results, including critically abnormal test results, abnormal cholesterol, abnormal HbA1c, abnormal pap smears and abnormal mammogram
3) Compliance to guidelines regarding the management of hypertension in the general ambulatory population and amongst ethnic minority groups
4) Compliance to guidelines regarding the screening and management of osteoporosis

Secondary Outcome Measures:

1) Patient satisfaction regarding communication with physicians
2) Physician satisfaction regarding follow-up of abnormal test results

Estimated Enrollment:	3000
Study Start Date:	September 2000
Estimated Study Completion Date:	December 2006

Show Detailed Description

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

All physicians in on-site and satellite adult outpatient clinics with the Brigham and Women's Hospital and Massachusetts General Hospital.
All practices must have adopted our home-grown electronic health record system, the Longitudinal Medical Record, for at least 24 months prior to the start of each intervention trial.

Exclusion Criteria:

None

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00225628

Locations

United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02472

Sponsors and Collaborators

Agency for Healthcare Research and Quality (AHRQ)

Investigators

Principal Investigator:

David W Bates, MD MSc

Brigham and Women's Hospital

More Information

Publications:

Hickner JM, Fernald DH, Harris DM, Poon EG, Elder NC, Mold JW. Issues and initiatives in the testing process in primary care physician offices. Jt Comm J Qual Patient Saf. 2005 Feb;31(2):81-9.

Poon EG, Gandhi TK, Sequist TD, Murff HJ, Karson AS, Bates DW. "I wish I had seen this test result earlier!": Dissatisfaction with test result management systems in primary care. Arch Intern Med. 2004 Nov 8;164(20):2223-8.

Poon EG, Wald J, Bates DW, Middleton B, Kuperman GJ, Gandhi TK. Supporting patient care beyond the clinical encounter: three informatics innovations from partners health care. AMIA Annu Symp Proc. 2003;:1072.

Gandhi TK, Sequist TD, Poon EG, Karson AS, Murff H, Fairchild DG, Kuperman GJ, Bates DW. Primary care clinician attitudes towards electronic clinical reminders and clinical practice guidelines. AMIA Annu Symp Proc. 2003;:848.

Poon EG, Wang SJ, Gandhi TK, Bates DW, Kuperman GJ. Design and implementation of a comprehensive outpatient Results Manager. J Biomed Inform. 2003 Feb-Apr;36(1-2):80-91.

Murff HJ, Gandhi TK, Karson AK, Mort EA, Poon EG, Wang SJ, Fairchild DG, Bates DW. Primary care physician attitudes concerning follow-up of abnormal test results and ambulatory decision support systems. Int J Med Inform. 2003 Sep;71(2-3):137-49.

Sequist TD, Gandhi TK, Karson AS, Fiskio JM, Bugbee D, Sperling M, Cook EF, Orav EJ, Fairchild DG, Bates DW. A randomized trial of electronic clinical reminders to improve quality of care for diabetes and coronary artery disease. J Am Med Inform Assoc. 2005 Jul-Aug;12(4):431-7. Epub 2005 Mar 31.

Poon EG, Haas JS, Louise Puopolo A, Gandhi TK, Burdick E, Bates DW, Brennan TA. Communication factors in the follow-up of abnormal mammograms. J Gen Intern Med. 2004 Apr;19(4):316-23.

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Matheny ME, Gandhi TK, Orav EJ, Ladak-Merchant Z, Bates DW, Kuperman GJ, Poon EG. Impact of an automated test results management system on patients' satisfaction about test result communication. Arch Intern Med. 2007 Nov 12;167(20):2233-9.

ClinicalTrials.gov Identifier:	NCT00225628 History of Changes
Other Study ID Numbers:	5 U18 HS011046
Study First Received:	September 22, 2005
Last Updated:	September 23, 2005
Health Authority:	United States: Federal Government

Keywords provided by Agency for Healthcare Research and Quality (AHRQ):

Computerized clinical decision support
Patient Safety
Quality of Care
Electronic Medical Records

Chronic Disease Management
Drug Monitoring
Guideline Adherence
Reminder Systems

Additional relevant MeSH terms:

Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Diabetes Mellitus
Hyperlipidemias
Hypertension
Osteoporosis
Heart Diseases
Cardiovascular Diseases
Arteriosclerosis

Arterial Occlusive Diseases
Vascular Diseases
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Dyslipidemias
Lipid Metabolism Disorders
Bone Diseases, Metabolic
Bone Diseases
Musculoskeletal Diseases

ClinicalTrials.gov processed this record on February 09, 2012