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.
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.
- Coronary Artery Disease
- Sickle Cell Disease
- Breast Cancer
- Congestive Heart Failure
- Renal Failure
- Attention Deficit Disorder With Hyperactivity
- Myasthenia Gravis
- Renal Insufficiency
- MAPLE Other
Intervention Desc: MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them. ARM 1: Kind: Experimental Label: Receive CDS intervention Description: Providers in clinics that will receive the CDS alert, as their clinic was randomized into our study.
- Allocation: Randomized
- Masking: Open Label
- Purpose: Diagnostic
- Endpoint: Efficacy Study
- Intervention: Parallel Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Intervention acceptance||6 months (May 2010-Nov2010)||No|
|Secondary||Problem list prevalence||pre and post intervention||No|
|Secondary||Problem list incidence||pre and post intervention||No|
|Secondary||Quality improvement based on problem list accuracy/completion||post intervention||No|