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- Title
Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: the CODES study protocol for a randomized controlled trial.
- Authors
Moja, Lorenzo; Friz, Hernan Polo; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; Gonzáez-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos; Polo Friz, Hernan; González-Lorenzo, Marien
- Abstract
<bold>Background: </bold>Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge.<bold>Methods/design: </bold>We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period.<bold>Discussion: </bold>The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES).<bold>Trial Registration: </bold>ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT02577198?term=NCT02577198&rank=1.
- Subjects
MEDICAL technology; HEALTH information technology; ELECTRONIC health records; THROMBOEMBOLISM; HEALTH care industry; COMPARATIVE studies; DECISION support systems; EXPERIMENTAL design; HOSPITALS; INFORMATION storage &; retrieval systems; MEDICAL databases; RESEARCH methodology; MEDICAL care; MEDICAL quality control; MEDICAL cooperation; PATIENTS; RESEARCH; EVIDENCE-based medicine; EVALUATION research; RANDOMIZED controlled trials
- Publication
Implementation Science, 2016, Vol 11, Issue 1, p1
- ISSN
1748-5908
- Publication type
journal article
- DOI
10.1186/s13012-016-0455-x