NCT00581711

Improving Otitis Media Care With Clinical Decision Support

Improving Otitis Media Care With EHR-based Clinical Decision Support and Feedback

• Status: Completed
• Phase: Phase 3
• Study type: Interventional
• Enrollment: 55,779 (actual)
• Sponsor: Children's Hospital of Philadelphia · Academic / Other
• Sex: All
• Age: 2 Months – 18 Years
• Healthy volunteers: Not accepted

Summary

This protocol will prospectively develop a new electronic health record (EHR)-based health information technology (IT) intervention that a) summarizes Otitis Media (OM) care into clinically meaningful episodes-of-care, b) provides clinical decision support based upon evidence-based guidelines to primary care and ENT physicians working within an integrated physician network that uses a common EHR, and c) tests the additive effects on quality and resource utilization of providing feedback to physicians.

Detailed description

Context The high prevalence of Otitis Media (OM) and its enormous cost make it a prime target for cost-effective and evidence-based strategies for disease management. Objectives This protocol will prospectively develop a new electronic health record (EHR)-based health information technology (IT) intervention that a) summarizes OM care into clinically meaningful episodes-of-care, b) provides clinical decision support based upon evidence-based guidelines to primary care and ENT physicians working within an integrated physician network that uses a common EHR, and c) tests the additive effects on quality and resource utilization of providing feedback to physicians. The specific aims are: Aim 1: To develop and pilot test the OM health IT intervention; Aim 2: To examine the overall effect of the health IT intervention and the independent contribution of physician feedback on quality of OM care (primary outcomes); Aim 3: To assess the effects of the intervention on the secondary outcomes of health care resource utilization and clinician adoption of the health IT. Study Design/Settings/Participants A cluster randomized trial and multi-level statistical modeling will be used to estimate health IT intervention effects on study outcomes. The proposed project will be conducted in the Children's Hospital of Philadelphia's (CHOP) health care system. The heath IT intervention will be tested in the Pediatric Research Consortium (PeRC), which includes 28 primary care practices in the CHOP network, both urban and suburban, and the CHOP ENT clinical sites. Randomization and implementation of the intervention will occur at the practice level. Study outcomes of quality of care and resource utilization will be reported at the levels of the practice, individual practitioner, and episode-of-care (patient-level). Study Measures Our main study measures include the quality of otitis media care provided during episodes of OM. Our secondary outcomes include measurement of clinician adoption of the health IT intervention and resource use.

Conditions

• Otitis Media

Interventions

Type	Name	Description
OTHER	3-Part Intervention	A combination of training, an otitis media episode grouper, and clinical decision support.
OTHER	4-Part Intervention	A combination of clinician training, an otitis media episode grouper, clinical decision support, and feedback.
OTHER	1-part intervention	Provision of feedback on otitis media quality indicators

Timeline

• Start date: 2007-12-01
• Primary completion: 2010-09-01
• Completion: 2010-09-01
• First posted: 2007-12-28
• Last updated: 2012-06-18

Locations

1 site across 1 country: United States