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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: February 2, 2017
Last verified: February 2017

April 18, 2012
February 2, 2017
April 2012
October 2012   (Final data collection date for primary outcome measure)
The Number of People Who Responded to a Prompt [ Time Frame: 1 year ]
The main outcome of interest is whether or not a prompt was answered (discussed/not discussed).
Increased prompt response [ Time Frame: 1 year ]
The main outcome of interest is whether or not a prompt was answered (discussed/not discussed).
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
Not Provided
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Outcomes Assessor
Primary Purpose: Health Services Research
Physician Behavior
  • Other: Receiving Highlighted Prompts
    These patients received highlighted prompts.
  • Other: Receiving Non-highlighted Prompts
    These patients received prompts that were not highlighted.
  • Experimental: Receiving Highlighted Prompts
    These patients received highlighted prompts.
    Intervention: Other: Receiving Highlighted Prompts
  • Active Comparator: Receiving Non-highlighted Prompts
    These patients received prompts that were not highlighted.
    Intervention: Other: Receiving Non-highlighted Prompts
Not Provided

*   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
Sexes Eligible for Study: All
Child, Adult, Senior
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
 
NCT01583101
CHICA_Highlight_Study
No
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No
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Aaron Carroll, Indiana University
Indiana University
Not Provided
Principal Investigator: Aaron E Carroll, MD, MS Indiana University School of Medicine
Indiana University
February 2017

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