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Study of an Intervention to Improve Problem List Accuracy and Use (MAPLE)

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ClinicalTrials.gov Identifier: NCT01105923
Recruitment Status : Unknown
Verified January 2015 by Adam Wright, Brigham and Women's Hospital.
Recruitment status was:  Active, not recruiting
First Posted : April 19, 2010
Last Update Posted : February 2, 2015
Sponsor:
Information provided by (Responsible Party):

Study Description
Brief Summary:
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 or disease Intervention/treatment
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

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.


Study Design

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 140 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Making Accurate Problem Lists in the EHR
Study Start Date : May 2010
Primary Completion Date : November 2010
Estimated Study Completion Date : November 2017

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
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


Outcome Measures

Primary Outcome Measures :
  1. Intervention acceptance [ Time Frame: 6 months (May 2010-Nov2010) ]
    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.


Secondary Outcome Measures :
  1. Problem list prevalence [ Time Frame: pre and post intervention ]
    Number of patients with selected problems on their problem list pre and post intervention across intervention and control groups.

  2. Problem list incidence [ Time Frame: pre and post intervention ]
    For the conditions of interest, the percent of patients that had the problem added during the study period

  3. Quality improvement based on problem list accuracy/completion [ Time Frame: post intervention ]
    For those with problems added due to the intervention, the number of new triggered reminders or other clinical actions.


Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Independent healthcare provider (physician, NP, PA)
  • Practices at participating site

Exclusion Criteria:

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01105923


Locations
United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Brigham and Women's Hospital
Investigators
Principal Investigator: Adam Wright, PhD Brigham and Women's Hospital
More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Adam Wright, Senior Scientist, Brigham and Women's Hospital
ClinicalTrials.gov Identifier: NCT01105923     History of Changes
Other Study ID Numbers: 2009P001846
First Posted: April 19, 2010    Key Record Dates
Last Update Posted: February 2, 2015
Last Verified: January 2015

Additional relevant MeSH terms:
Heart Failure
Coronary Artery Disease
Myocardial Ischemia
Coronary Disease
Osteoporosis
Attention Deficit Disorder with Hyperactivity
Anemia, Sickle Cell
Renal Insufficiency
Bone Diseases, Metabolic
Hypothyroidism
Myasthenia Gravis
Hyperthyroidism
Heart Diseases
Cardiovascular Diseases
Arteriosclerosis
Arterial Occlusive Diseases
Vascular Diseases
Bone Diseases
Musculoskeletal Diseases
Metabolic Diseases
Attention Deficit and Disruptive Behavior Disorders
Neurodevelopmental Disorders
Mental Disorders
Anemia, Hemolytic, Congenital
Anemia, Hemolytic
Anemia
Hematologic Diseases
Hemoglobinopathies
Genetic Diseases, Inborn
Kidney Diseases