Title

Electronic health record-based decision support to improve asthma care: a cluster-randomized trial.

Year of Publication

2010

Number of Pages

e770-7

Date Published

2010 Apr

ISSN Number

1098-4275

Abstract

<p><strong>OBJECTIVE: </strong>Asthma continues to be 1 of the most common chronic diseases of childhood and affects approximately 6 million US children. Although National Asthma Education Prevention Program guidelines exist and are widely accepted, previous studies have demonstrated poor clinician adherence across a variety of populations. We sought to determine if clinical decision support (CDS) embedded in an electronic health record (EHR) would improve clinician adherence to national asthma guidelines in the primary care setting.</p>

<p><strong>METHODS: </strong>We conducted a prospective cluster-randomized trial in 12 primary care sites over a 1-year period. Practices were stratified for analysis according to whether the site was urban or suburban. Children aged 0 to 18 years with persistent asthma were identified by International Classification of Diseases, Ninth Revision codes for asthma. The 6 intervention-practice sites had CDS alerts imbedded in the EHR. Outcomes of interest were the proportion of children with at least 1 prescription for controller medication, an up-to-date asthma care plan, and the performance of office-based spirometry.</p>

<p><strong>RESULTS: </strong>Increases in the number of prescriptions for controller medications, over time, was 6% greater (P = .006) and 3% greater for spirometry (P = .04) in the intervention urban practices. Filing an up-to-date asthma care plan improved 14% (P = .03) and spirometry improved 6% (P = .003) in the suburban practices with the intervention.</p>

<p><strong>CONCLUSION: </strong>In our study, using a cluster-randomized trial design, CDS in the EHR, at the point of care, improved clinician compliance with National Asthma Education Prevention Program guidelines.</p>

DOI

10.1542/peds.2009-1385

Alternate Title

Pediatrics

PMID

20231191

WATCH THIS PAGE

Subscription is not available for this page.