Study of an Intervention to Improve Problem List Accuracy and Use

Breast Cancer Clinical Trial

— MAPLE  

Official title:

Making Accurate Problem Lists in the EHR

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01105923
• Other study ID #: 2009P001846
• Status: Active, not recruiting
• Phase: N/A
• First received: April 15, 2010
• Last updated: January 30, 2015
• Start date: May 2010
• Est. completion date: November 2017

Study information

• Verified date: January 2015
• Source: Brigham and Women's Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to identify patients with problem list gaps and intervene to correct these gaps by creating clinical decision support interventions that alert providers to likely problem list gaps and offer clinicians the opportunity to correct them. The investigators will randomize the clinics that will receive the intervention and formally evaluate the study after a period of 6 months for improved problem list completeness to determine the effectiveness of our intervention.

Description:

The clinical problem list is a cornerstone of the problem-oriented medical record. Problem lists are used in a variety of ways throughout the process of clinical care. In addition to its use by clinicians, the problem list is also critical for decision support and quality measurement.

Patients with gaps in their problem list face significant risks. For example, if a hypothetical patient has diabetes properly documented, his clinician would receive appropriate alerts and reminders to guide care. Additionally, the patient might be included in special care management programs and the quality of care provided to him would be measured and tracked. Without diabetes on his problem list, he might receive none of these benefits.

In this study, the investigators developed an clinical decision support intervention that will identify patients with problem lists gaps. The investigators will alert providers of these likely gaps and offer providers the opportunity to correct them.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 140
• Est. completion date: November 2017
• Est. primary completion date: November 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Independent healthcare provider (physician, NP, PA)

• Practices at participating site

Exclusion Criteria:

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic

Related Conditions & MeSH terms

• Anemia, Sickle Cell
• Asthma
• Attention Deficit Disorder With Hyperactivity
• Breast Cancer
• Congestive Heart Failure
• COPD
• Coronary Artery Disease
• Coronary Disease
• Diabetes
• Glaucoma
• Heart Failure
• Hemophilia
• Hypertension
• Hyperthyroidism
• Hypothyroidism
• Myasthenia Gravis
• Myocardial Ischemia
• Osteopenia
• Osteoporosis
• Renal Failure
• Renal Insufficiency
• Sickle Cell Disease
• Stroke

Intervention

Other:
• MAPLE
MAPLE is a CDS intervention within the EHR that will alert providers to problem lists gaps and present an opportunity to correct them.

Locations

Country	Name	City	State
United States	Brigham and Women's Hospital	Boston	Massachusetts

Sponsors (1)

Lead Sponsor	Collaborator
Brigham and Women's Hospital

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Intervention acceptance	Of those providers who were shown (or who would have been shown, for the control group) the intervention, the number that added a problem across control and intervention groups.	6 months (May 2010-Nov2010)	No
Secondary	Problem list prevalence	Number of patients with selected problems on their problem list pre and post intervention across intervention and control groups.	pre and post intervention	No
Secondary	Problem list incidence	For the conditions of interest, the percent of patients that had the problem added during the study period	pre and post intervention	No
Secondary	Quality improvement based on problem list accuracy/completion	For those with problems added due to the intervention, the number of new triggered reminders or other clinical actions.	post intervention	No