CDS system grows on pediatricians

Pediatrician satisfaction with a decision support system grew over time and a development team working with their feedback is refining it further, according to a study published in the Journal of the Medical Informatics Association.

Researchers from the Indiana University School of Medicines and Regenstrief Institute for Healthcare in Indianapolis sought to assess the opinions of users of the Child Health Improvement through Computer Automation system (CHICA), a decision support system linked to an electronic health record. They surveyed 70 users of the system at four busy pediatric clinics in 2011, and 64 in 2012.

Upon check-in, the system produced a paper checklist of 20 questions for the parent to fill out based on the child's age and development at the time of the visit. That checklist had to be scanned back in and was automatically added to the EHR. It then printed out a physician worksheet with prompts based on recommendations from the American Academy of Pediatrics (AAP), and automatically printed out "just-in-time" handouts the physician could give to the parents, if deemed appropriate.

Despite initial mixed feelings about the system, users' acceptance of the system grew in just 12 months. Users said that CHICA sometimes reminded them of things that might otherwise have been forgotten (54 percent in 2011 vs. 72 percent in 2012); made documentation easier (46 percent in 2011 vs. 61 percent in 2012); uncovered issues with patients that otherwise would not have been found (44 percent in 2011 vs. 63 percent in 2012); felt the reminders were consistent with recommended practices (57 percent in 2011 vs. 72 percent in 2012); and that the CHICA handouts were useful (66 percent in 2011 vs. 83 percent in 2012).

Pediatricians have long argued that existing health IT systems don't really meet their needs. The AAP has been working with the Centers for Medicare & Medicaid Services and the Agency for Healthcare Research and Quality to provide guidance for vendors on improving their products.  

A report published last week by the Verizon Foundation and Boston Children's Hospital, however, stressed that technology such as mobile applications and web portals, could improve care coordination for children with complex chronic conditions.

And email and smartphones can be important ways for urban pediatric clinics to communicate with underserved populations, according to a study from Cincinnati Children's Hospital Medical Center.

To learn more:
- here's the abstract
- read the research

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