The effectiveness of an electronic clinical decision support tool embedded into the patient medical record at the point of care to guide Mohs surgery utilization: A cohort study

Author(s):  
Sepideh Ashrafzadeh ◽  
Sameer Gupta ◽  
Anne-Maria Fiorino ◽  
Elizabeth T. Cafiero-Fonseca ◽  
Timothy G. Ferris ◽  
...  
2018 ◽  
Vol 18 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Elyse Olshen Kharbanda ◽  
Stephen E. Asche ◽  
Alan Sinaiko ◽  
James D. Nordin ◽  
Heidi L. Ekstrom ◽  
...  

2021 ◽  
Vol 21 (2) ◽  
pp. 904-911
Author(s):  
Alison Annet Kinengyere ◽  
Julie Rosenberg ◽  
Olivia Pickard ◽  
Moses Kamya

Background: The use of point-of-care, evidence-based tools is becoming increasingly popular. They can provide easy-to- use, high-quality information which is regularly updated and has been shown to improve clinical outcomes. Integrating such tools into clinical practice is an important component of improving the quality of health care. However, because such tools are rarely used in resource-limited settings, there is limited research on uptake especially among medical students. Objective: This paper explores the uptake of one such tool, Up-To-Date, when provided free of cost at a medical school in Africa. Methods: In partnership with the Better Evidence at Ariadne Labs free access to UpToDate was granted through the MakCHS IP address. On-site librarians facilitated training sessions and spread awareness of the tool. Usage data was aggre- gated, based on log ins and content views, presented and analyzed using Excel tables and graphs. Results: The data shows evidence of meaningful usage, with 43,043 log ins and 15,591 registrations between August 2019 and August 2020. The most common topics viewed were in obstetrics and gynecology, pediatrics, drug information, and infectious diseases. Access occurred mainly through the mobile phone app. Conclusion: Findings show usage by various user categories, but with inconsistent uptake and low usage. Librarians can draw upon these results to encourage institutions to support uptake of point-of-care tools in clinical practice. Keywords: UpToDate clinical decision support tool; Makerere University College of Health Sciences; Uganda.


BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019087 ◽  
Author(s):  
Maya Elizabeth Kessler ◽  
Rickey E Carter ◽  
David A Cook ◽  
Daryl Jon Kor ◽  
Paul M McKie ◽  
...  

IntroductionClinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that presents guideline-relevant information and actionable items to clinicians at the point of care. We aim to test whether this tool improves the management of hyperlipidaemia, atrial fibrillation and heart failure by primary care clinicians.Methods/analysisClinician care teams were cluster randomised to receive access to the clinical decision support tool or passive access to institutional guidelines on 16 May 2016. The trial began on 1 June 2016 when access to the tool was granted to the intervention clinicians. The trial will be run for 6 months to ensure a sufficient number of patient encounters to achieve 80% power to detect a twofold increase in the primary outcome at the 0.05 level of significance. The primary outcome measure will be the percentage of guideline-based recommendations acted on by clinicians for hyperlipidaemia, atrial fibrillation and heart failure. We hypothesise care teams with access to the clinical decision support tool will act on recommendations at a higher rate than care teams in the standard of care arm.Ethics and disseminationThe Mayo Clinic Institutional Review Board approved all study procedures. Informed consent was obtained from clinicians. A waiver of informed consent and of Health Insurance Portability and Accountability Act (HIPAA) authorisation for patients managed by clinicians in the study was granted. In addition to publication, results will be disseminated via meetings and newsletters.Trial registration numberNCT02742545.


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