Đang chuẩn bị liên kết để tải về tài liệu:
báo cáo khoa học: "Rationale, design, and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR) randomized trial in primary care"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Rationale, design, and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR) randomized trial in primary care | Mann et al. Implementation Science 2011 6 109 http www.implementationscience.eom content 6 1 109 Implementation Science IMPLEMENTATION SCIENCE STUDY PROTOCOL Open Access Rationale design and implementation protocol of an electronic health record integrated clinical prediction rule iCPR randomized trial in primary care 1 2 2 2 2 2 Devin M Mann Joseph L Kannry Daniel Edonyabo Alice C Li Jacqueline Arciniega James Stulman Lucas Romero2 Juan Wisnivesky2 Rhodes Adler2 and Thomas G McGinn3 Abstract Background Clinical prediction rules CPRs represent well-validated but underutilized evidence-based medicine tools at the point-of-care. To date an inability to integrate these rules into an electronic health record EHR has been a major limitation and we are not aware of a study demonstrating the use of CPR s in an ambulatory EHR setting. The integrated clinical prediction rule iCPR trial integrates two CPR s in an EHR and assesses both the usability and the effect on evidence-based practice in the primary care setting. Methods A multi-disciplinary design team was assembled to develop a prototype iCPR for validated streptococcal pharyngitis and bacterial pneumonia CPRs. The iCPR tool was built as an active Clinical Decision Support CDS tool that can be triggered by user action during typical workflow. Using the EHR CDS toolkit the iCPR risk score calculator was linked to tailored ordered sets documentation and patient instructions. The team subsequently conducted two levels of real world usability testing with eight providers per group. Usability data were used to refine and create a production tool. Participating primary care providers n 149 were randomized and intervention providers were trained in the use of the new iCPR tool. Rates of iCPR tool triggering in the intervention and control simulated groups are monitored and subsequent use of the various components of the iCPR tool among intervention encounters is also tracked. The primary outcome is the difference in .