Otitis Media Clinical Trial
Official title:
Improving Otitis Media Care With EHR-based Clinical Decision Support and Feedback
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.
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.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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