Study of an Intervention to Improve Problem List Accuracy and Use (MAPLE)
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Purpose
The aim of this study is to identify patients with problem list gaps and intervene to correct these gaps by creating clinical decision support interventions that alert providers to likely problem list gaps and offer clinicians the opportunity to correct them. The investigators will randomize the clinics that will receive the intervention and formally evaluate the study after a period of 6 months for improved problem list completeness to determine the effectiveness of our intervention.
| Condition | Intervention |
|---|---|
|
Attention Deficit Disorder With Hyperactivity Asthma COPD Breast Cancer Coronary Artery Disease Congestive Heart Failure Diabetes Glaucoma Hemophilia Hypertension Hyperthyroidism Hypothyroidism Myasthenia Gravis Osteoporosis Osteopenia Renal Failure Renal Insufficiency Sickle Cell Disease Stroke |
Other: MAPLE |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | Making Accurate Problem Lists in the EHR |
- Intervention acceptance [ Time Frame: 6 months (May 2010-Nov2010) ] [ Designated as safety issue: No ]Of those providers who were shown (or who would have been shown, for the control group) the intervention, the number that added a problem across control and intervention groups.
- Problem list prevalence [ Time Frame: pre and post intervention ] [ Designated as safety issue: No ]Number of patients with selected problems on their problem list pre and post intervention across intervention and control groups.
- Problem list incidence [ Time Frame: pre and post intervention ] [ Designated as safety issue: No ]For the conditions of interest, the percent of patients that had the problem added during the study period
- Quality improvement based on problem list accuracy/completion [ Time Frame: post intervention ] [ Designated as safety issue: No ]For those with problems added due to the intervention, the number of new triggered reminders or other clinical actions.
| Estimated Enrollment: | 140 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | November 2010 |
| Estimated Primary Completion Date: | November 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Receive CDS intervention
Providers in clinics that will receive the CDS alert, as their clinic was randomized into our study.
|
Other: MAPLE
MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them.
|
| No Intervention: No CDS intervention |
Detailed Description:
The clinical problem list is a cornerstone of the problem-oriented medical record. Problem lists are used in a variety of ways throughout the process of clinical care. In addition to its use by clinicians, the problem list is also critical for decision support and quality measurement.
Patients with gaps in their problem list face significant risks. For example, if a hypothetical patient has diabetes properly documented, his clinician would receive appropriate alerts and reminders to guide care. Additionally, the patient might be included in special care management programs and the quality of care provided to him would be measured and tracked. Without diabetes on his problem list, he might receive none of these benefits.
In this study, the investigators developed an clinical decision support intervention that will identify patients with problem lists gaps. The investigators will alert providers of these likely gaps and offer providers the opportunity to correct them.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Independent healthcare provider (physician, NP, PA)
- Practices at participating site
Exclusion Criteria:
- None
Contacts and Locations| United States, Massachusetts | |
| Brigham and Women's Hospital | |
| Boston, Massachusetts, United States, 02115 | |
| Principal Investigator: | Adam Wright, PhD | Brigham and Women's Hospital |
More Information
No publications provided by Brigham and Women's Hospital
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Adam Wright, PhD, Brigham and Women's Hospital |
| ClinicalTrials.gov Identifier: | NCT01105923 History of Changes |
| Other Study ID Numbers: | 2009P001846 |
| Study First Received: | April 15, 2010 |
| Last Updated: | April 16, 2010 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Myasthenia Gravis Anemia, Hemolytic, Congenital Anemia, Sickle Cell Asthma Breast Neoplasms Coronary Artery Disease Myocardial Ischemia Coronary Disease Glaucoma Heart Failure Hemophilia A Hypertension Hyperthyroidism Hypothyroidism Bone Diseases, Metabolic |
Osteoporosis Renal Insufficiency Stroke Attention Deficit Disorder with Hyperactivity Hyperkinesis Anemia, Hemolytic Anemia Hematologic Diseases Hemoglobinopathies Genetic Diseases, Inborn Bronchial Diseases Respiratory Tract Diseases Lung Diseases, Obstructive Lung Diseases Respiratory Hypersensitivity |
ClinicalTrials.gov processed this record on May 23, 2013