Clinical prediction rules could improve quality, reduce costs--if only docs would use them

Electronic health record systems integrated with clinical prediction rules (CPRs) can improve quality of care, contain costs and reduce overtreatment, according to a new study in JAMA Internal Medicine.

CPRs assess a patient's lab results, history and other factors and aid providers by estimating the probability of disease or potential response to a treatment.

A team that included researchers from Mount Sinai School of Medicine found that providers have yet to incorporate CPRs into their every day care. The researchers developed a randomized clinical trial to determine if CPRs were effective in face-to-face primary care settings and have an impact on how doctors order tests and prescribe medications.

They used two well-validated CPRs, one for streptococcal pharyngitis and one for pneumonia, integrated into the EHRs of providers that were part of Mount Sinai's Division of General Internal Medicine.  

The intervention group completed the CPR in 57.5 percent of patient visits. Providers in the intervention group were "significantly" less likely to order antibiotics or a rapid strep test.

"The integrated clinical prediction rule process for integrating complex evidence-based clinical decision report tools is of relevant importance for national initiatives, such as Meaningful Use," the researchers wrote.

EHRs continue to prove their potential worth in helping providers predict patients at risk, such as the those more likely to have preterm births and those at higher risk of hospital readmission. Improving outcomes and reducing health care costs are primary goals of the Meaningful Use incentive program.  

To learn more:
- read the abstract

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