Using Computerized Provider Order Entry and Clinical Decision Support to Improve Referring Physicians' Implementation of Consultants' Medical Recommendations  

Oleh:

Were, Martin C. ; Abernathy, Greg ; Siu, L. Hui ; Kempf, Carol ; Weiner, Michael A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: JAMIA ( Journal Of the American Medical Informatics Association ) vol. 16 no. 2 (Mar. 2009), page 196.

Ketersediaan

Perpustakaan FK Nomor Panggil: J43.K.2009.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Objectives: Only half of consultants' medical recommendations are implemented. We created a tool that lets referring providers review and implement electronic recommendations made by consultants, with the hypothesis that facilitation with our tool could improve implementation. Measurements: The tool was piloted among geriatrics consultants and hospitalists. Pre-post evaluation was done with control (before pilot; N = 20) and intervention (after pilot; N = 20) patients. Consultants wrote notes containing recommendations for all study patients, and entered electronic recommendations only for intervention patients. We analyzed all recommendations and surveyed hospitalists. Results: A total of 249 recommendations were made for intervention patients versus 192 for controls (p < 0.05). Of all recommendations about intervention patients, 78% were implemented, compared to 59% for controls (p = 0.01). Of the intervention recommendations, 77% were entered electronically using our tool; of these, 86% were implemented. All 24 survey respondents indicated that the system improved quality, saved time, and should be expanded. Conclusion: Consultant recommendations were implemented 30% more often when there was electronic facilitation of recommendations.

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