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

April 18, 2012
November 13, 2012
April 2012
October 2012   (final data collection date for primary outcome measure)
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).
Same as current
Complete list of historical versions of study NCT01583101 on ClinicalTrials.gov Archive Site
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Child Health Improvement Through Computer Automation (CHICA) Highlighting Study
Increasing Prompt Response Rates in the CHICA System

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.

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).

Interventional
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Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
Physician Behavior
  • Other: Highlight set 1
    We will highlight two prompts.
  • Other: Highlight Set 2
    We will highlight 2 different prompts
  • Experimental: Highlighting Set 1
    We will randomize two prompts to be highlighted to see if it increases response rate.
    Intervention: Other: Highlight set 1
  • Experimental: Highlighting Set 2
    We will highlight two different prompts to see if response rate increases.
    Intervention: Other: Highlight Set 2
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
2237
October 2012
October 2012   (final data collection date for primary outcome measure)

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
Both
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Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT01583101
CHICA_Highlight_Study
No
Aaron Carroll, Indiana University
Indiana University
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Indiana University
November 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP