How Does the Clinical Tool 'What's Going Around' Affect Clinical Practice
| Status: | Completed |
|---|---|
| Conditions: | Asthma, Influenza, Infectious Disease, Infectious Disease |
| Therapuetic Areas: | Immunology / Infectious Diseases, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/21/2016 |
| Start Date: | November 2013 |
| End Date: | November 2014 |
Previous work has shown that the epidemiological context of a patient's presentation can
provide important information for clinicians to aid in diagnosis and treatment. With current
electronic health records, it is increasingly possible to perform syndromic surveillance
that is local and specific to a patient's characteristics.
The investigators have developed algorithms for syndromic surveillance for a number of
conditions in which contextual information might be of use to treating clinicians. The
syndromic surveillance algorithms already developed are for influenza-like-illness, whooping
cough, asthma exacerbation, Group A Streptococcal pharyngitis, and gastroenteritis
infection.
The investigators plan on studying these tools with a clustered randomized control cohort
study evaluating how clinical decision making is affected by use of these tools by
outpatient general practitioners. The goal is to incorporate these validated algorithms into
a quality improvement tool which will provide point-of-care clinical decision support to
clinicians
provide important information for clinicians to aid in diagnosis and treatment. With current
electronic health records, it is increasingly possible to perform syndromic surveillance
that is local and specific to a patient's characteristics.
The investigators have developed algorithms for syndromic surveillance for a number of
conditions in which contextual information might be of use to treating clinicians. The
syndromic surveillance algorithms already developed are for influenza-like-illness, whooping
cough, asthma exacerbation, Group A Streptococcal pharyngitis, and gastroenteritis
infection.
The investigators plan on studying these tools with a clustered randomized control cohort
study evaluating how clinical decision making is affected by use of these tools by
outpatient general practitioners. The goal is to incorporate these validated algorithms into
a quality improvement tool which will provide point-of-care clinical decision support to
clinicians
The epidemiological context of a patient's presentation can provide important information
for clinicians to aid in diagnosis and treatment. The investigators previously developed and
validated a syndromic surveillance tool for detecting influenza-like illness (ILI)
encounters. The investigators then evaluated 40,642 outpatient ILI episodes during 'flu
seasons' over 6 years. The investigators found that even after controlling for patient
presentation and physician factors, the context in which a patient presented was strongly
associated with the likelihood that an antimicrobial agent would be prescribed.
Specifically, patients were less likely to be prescribed an antibiotic if they presented
with ILI during the pandemic influenza period (when awareness of 'flu season' was very
high), or after their physician had personally seen many patients with ILI in the prior
week.
Currently, most clinicians have only limited access to data regarding the 'context' in which
a patient presents. Under such circumstances, physicians are often unaware of local
epidemiological information that could help them make optimal treatment decisions. In
centers with advanced use of electronic health records (EHRs), it is increasingly possible
to perform syndromic surveillance that is local (e.g. specific to a neighborhood or school
district), current (e.g. updated daily), and specific to a patient's characteristics (e.g.
age, chief complaint).
To that end, the investigators have developed algorithms for syndromic surveillance for a
number of syndromes including Asthma, ILI, Pertussis, Group A Streptococcus Pharyngitis, and
Gastroenteritis. These algorithms may provide contextual information that might be of use to
clinicians.
The purpose of this study is to determine the effect of how a point-of-care clinical
decision tool in the form of syndromic surveillance algorithms affect clinical decision
making amongst outpatient health care providers and also patient outcomes. We will be using
a 2 year look back prior to tool roll out as a comparison.
Specific Aims:
To determine the effect this point-of-care clinical decision tool has on clinical decision
making amongst primary care providers.
To determine the clinical outcomes of patients whose physicians had access to these tools
To understand how these point-of-care clinical decision tools are used among healthcare
providers in day to day practice
for clinicians to aid in diagnosis and treatment. The investigators previously developed and
validated a syndromic surveillance tool for detecting influenza-like illness (ILI)
encounters. The investigators then evaluated 40,642 outpatient ILI episodes during 'flu
seasons' over 6 years. The investigators found that even after controlling for patient
presentation and physician factors, the context in which a patient presented was strongly
associated with the likelihood that an antimicrobial agent would be prescribed.
Specifically, patients were less likely to be prescribed an antibiotic if they presented
with ILI during the pandemic influenza period (when awareness of 'flu season' was very
high), or after their physician had personally seen many patients with ILI in the prior
week.
Currently, most clinicians have only limited access to data regarding the 'context' in which
a patient presents. Under such circumstances, physicians are often unaware of local
epidemiological information that could help them make optimal treatment decisions. In
centers with advanced use of electronic health records (EHRs), it is increasingly possible
to perform syndromic surveillance that is local (e.g. specific to a neighborhood or school
district), current (e.g. updated daily), and specific to a patient's characteristics (e.g.
age, chief complaint).
To that end, the investigators have developed algorithms for syndromic surveillance for a
number of syndromes including Asthma, ILI, Pertussis, Group A Streptococcus Pharyngitis, and
Gastroenteritis. These algorithms may provide contextual information that might be of use to
clinicians.
The purpose of this study is to determine the effect of how a point-of-care clinical
decision tool in the form of syndromic surveillance algorithms affect clinical decision
making amongst outpatient health care providers and also patient outcomes. We will be using
a 2 year look back prior to tool roll out as a comparison.
Specific Aims:
To determine the effect this point-of-care clinical decision tool has on clinical decision
making amongst primary care providers.
To determine the clinical outcomes of patients whose physicians had access to these tools
To understand how these point-of-care clinical decision tools are used among healthcare
providers in day to day practice
Inclusion Criteria:
All patients seen in a Northshore University HealthSystem outpatient clinic (Family
Medicine, Internal Medicine or Pediatric) between the Nov 1 2013 to Oct 31 2014
Exclusion Criteria:
We found this trial at
1
site
Click here to add this to my saved trials
