Asthma Clinical Trial
Official title:
EHR Decision Support to Improve Outpatient Asthma Care
The Children's Hospital of Philadelphia's ambulatory network uses an electronic health record (EHR) to document clinical information. Using the EHR, a clinical decision support tool will be designed to help the primary care physician's in caring for children with asthma. The goal will be to improve the primary care physician's use of the national Institutes of Health guidelines for the best care for asthma. To study this EHR decision support tool, it will be introduced into 5 practices while 5 other practices will have the existing asthma care information. It will be determined whether the physicians in the practices with the decision support tool are better at following the asthma guidelines. If the decision support tool works...then it will be offered to others to use with their EHR systems.
National Asthma Education and Prevention Program guidelines (NAEPP) exist, but are under
used in Primary Care. In addition, implementation of the guidelines has been shown to be
vary according to the location of practice and other contextual factors.
The Children's Hospital of Philadelphia Pediatric Research Consortium (PeRC), a
practice-based research network will determine whether an innovative clinical decision
support system embedded in an existing electronic health record (EHR) will improve provider
adherence to the existing NAEPP guidelines.
After receiving a standardized education module based on NAEPP guidelines, 10 primary care
pediatric practices (both urban and suburban) will be randomized to receive either a passive
EHR (control sites) or an interactive decision support sytem (intervention sites).
The primary outcome of interest will be the proportion of patient son appropriate asthma
controller medication compared over time. Secondary outcomes include the proportion of
asthma patients with: 1) an updated asthma action plan 2) documentation of spirometry
performed (6 to 17years) and 3) an updated problem list reflecting current asthma severity.
After hours calls to providers and types of office visits related to to asthma will be
tracked. Contextual factors at the clinic and patient level will be examined to assess their
association with the outcomes of interest. In addition, measurement of asthma-related
quality of life and missed school and work in a sample of 200 subjects from each group will
be performed
If shown to be successful, this type of clinical decision support, embedded within the EHR,
has the potential to be a powerful tool to improve the implementation of asthma guidelines
and clinical practice guidelines for other conditions and illnesses.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label
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