CHICA-CN Evaluation - Evaluation of a Computer Decision Support System in Child Neurology
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 455
- 试验地点
- 1
- 主要终点
- Chart Abstraction Outcomes - Transitions of Care
研究概览
简要总结
The study will evaluate a computer decision support system for child neurology, Child Health Improvement through Computer Automation - Child Neurology (CHICA-CN) using patient chart review, family phone surveys, and physician interviews in a before-after study design.
详细描述
(CHICA-CN) Child Health Improvement through Computer Automation - Child Neurology is software that works with the electronic health record (EHR) to improve the efficiency and quality of care in the outpatient setting. Built in partnership with the Child Neurology Foundation, CHICA's guidance is based on authoritative guidelines from the American Academy of Neurology and others. The plan is to implement CHICA-CN in the Child Neurology Clinics at Wake Forest Baptist Health. To evaluate CHICA-CN the proposal is to look at data derived from three sources:
- Chart Review to evaluate quality of care based on measures derived from four algorithms developed from American Academy of Neurology quality measures and typically documented in the medical record. This will be a before-after study design in which measurements will be obtained before and after the installation of CHICA-CN.
- Parent Phone Surveys to Document the parent experience in terms of physician-patient communication, parent engagement, and satisfaction with use of the patient facing tablet interface. These data will be collected from families of patients identified for the chart review after the intervention.
- Physician user satisfaction measures, including perceived value of the system and ease of use in general and as regards individual clinical issues. Surveys will be administered to physicians and clinic staff who used CHICA-CN.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- — 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Must be patients in the participating clinical practices meeting inclusion criteria for one of the four cohorts
排除标准
- 未提供
结局指标
主要结局
Chart Abstraction Outcomes - Transitions of Care
时间窗: Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN
Transitions of Care - the number of charts that document that the service was provided divided by the number of charts reviewed
Chart Abstraction Outcomes - Genetic Testing for Global Developmental Delay
时间窗: Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN
Genetic Testing for Global Developmental Delay - the number of charts that document that the service was provided divided by the number of charts reviewed
Chart Abstraction Outcomes - Rescue Seizure Therapy for Children with Epilepsy
时间窗: Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN
Rescue Seizure Therapy for Children with Epilepsy - the number of charts that document that the service was provided divided by the number of charts reviewed
Chart Abstraction Outcomes - Adolescent Depression Screening
时间窗: Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN
Adolescent Depression Screening - the number of charts that document that the service was provided divided by the number of charts reviewed
Physician-patient communication Survey Score
时间窗: Eligible patients will be identified as they have encounters, starting 6 months after implementation of CHICA-CN and continuing for 12 months, assessed for the identified visit, within 2 weeks of the visit
Communication subscale of the Ambulatory Care Experiences (ACE) Survey - includes 4 items like "How often did your personal doctor explain things in a way that was easy to understand" or "How would you rate your personal doctor's knowledge of your medical history." - Single score (0-12), higher score indicates better communication.
Physician Satisfaction Survey
时间窗: After one year of of clinicians using CHICA-CN
Clinician user satisfaction measures, including perceived value of the system and ease of use in general and as regards individual clinical issues. Surveys will be administered to physicians and clinic staff who used CHICA-CN. The survey includes a series of statements with which the respondent will mark their level of agreement on a Likert scale. There is no summary score, but we will calculate and report a mean, median, and range for each item.
Patient engagement Survey Score
时间窗: Eligible patients will be identified as they have encounters, starting 6 months after implementation of CHICA-CN and continuing for 12 months, assessed for the identified visit, within 2 weeks of the visit
Patient Activation Measure Short Form (PAM) - 13 item scale assesses whether the parent believes an active role in the child's care is important; if the parent has the confidence and knowledge to take action, e.g., medications, bringing concerns to the provider; if the parent has taken action, e.g., lifestyle changes, to improve child's health; and whether the parent stays on course under stress, e.g., being able to handle child's health condition at home. 13 items, single score (0-39), higher score indicates greater patient/parent engagement.
次要结局
未报告次要终点