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

Active, not recruiting

Phase N/A Results N/A

Trial Description

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.

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.



  • 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.

Trial Design

  • 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