We had some interesting studies appear over the break.
December 22, 2010 | Molly Merrill, Associate Editor
CHICAGO – An electronic health system that alerts physicians with a yellow light when problems exist with a patient's care is being used by doctors at Northwestern Medicine. The system goes one step further by tying docs' responses to the alerts to quarterly performance reports.
Forty primary care physicians at Northwestern Medicine were part of a study which showing that, after one year of using the new system, it had significantly improved doctors' performance and the healthcare of patients with chronic conditions such as diabetes and cardiovascular disease. It also boosted preventive care in vaccinations and cancer and osteoporosis screenings.
Among the improvements: the number of heart disease patients receiving cholesterol-lowering medication rose from 87 to 93 percent, pneumonia vaccinations increased from 80 to 90 percent, and colon cancer screenings from 57 to 62 percent.
"The gains are modest, but if you are already at 90 percent and go to 94 percent, that's important," said lead author Stephen Persell, MD, an assistant professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital.
"It helps us find needles in the haystack and focus on patients who really have outstanding needs that may have slipped between the cracks," said Persell, who is also a researcher in the division of general internal medicine.
"Quality healthcare is not just about having good doctors and nurses taking care of you," he added. "It's having systems in place that make it easier for them to do their jobs and insure that patients get what they need."
The study is published online in the journal Medical Care and in the February print issue.
January 04, 2011 | Molly Merrill, Associate Editor
SEATTLE – Clinical decision support systems can help reduce inappropriate medical imaging, including unnecessary computed tomography (CT) and magnetic resonance imaging (MRI) scans, according to a recent study.
Conducted by researchers from Virginia Mason Medical Center in Seattle, the study was published in the January issue of the Journal of the American College of Radiology.
"Clinical decision support systems are point-of-order decision aids, usually through computer order entry systems, that provide real-time feedback to providers ordering imaging tests, including information on test appropriateness for specific indications," said C. Craig Blackmore, MD, MPH, lead author of the study. "Such systems may be purely educational, or they may be restrictive in not allowing imaging test ordering to proceed when accepted indications are absent."
A retrospective cohort study was performed of the staged implementation of evidence-based clinical decision support built into ordering systems for selected high-volume imaging procedures: lumbar magnetic resonance imaging (MRI), brain MRI, and sinus computed tomography (CT). Imaging utilization rates and overall imaging utilization before and after the intervention were determined.
Click here to read the full study.
Just two more bricks in the wall regarding safety and quality improvements flowing from clinician decision support.