Veterans Affairs Integrated Medication Manager
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Utah
- Enrollment
- 58
- Locations
- 2
- Primary Endpoint
- Amount of Time to Complete Assessment and Plan
Study Overview
Brief Summary
The purpose of this study is to advance the science of healthcare informatics and to improve medication management through the development of a new approach to the electronic medical record called the Integrated Medication Manager (IMM).
Detailed Description
In an attempt to address problems patient non-compliance with quality goals barriers to access and integration of health information that impede achievement of treatment goals, the VA is developing a new approach to the electronic medical record. The VA is moving away from the paper-chart metaphor and towards an integrated representation of the patient's status and care process across time. One of the first steps in the development phase has been to explicitly relate patient conditions, therapies, and goals in the domain of pharmacotherapy. This is called Integrated Medication Management and draws on Hollnagel's Contextual Control Model. Providers will be able to plan care and create orders directly in the context of these explicit relationships. This application will be implemented nationwide through a web interface embedded within the existing Computerized Patient Record System (CPRS), the graphical user interface to VA Information Systems (VistA).
Aim 1: Identify cognitive components of providers' therapeutic decision making in the field.
Aim 2. Refine and evaluate the Integrated Medication Manager using simulation studies.
- Aim 2.a. Refine interfaces and logic of the Integrated Medication Manager.
- Aim 2.b. Compare the performance of the Integrated Medication Manager and usual CPRS.
All hypotheses (below) test the use of IMM versus usual electronic medical record (EMR).
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Practiced in primary care for at least two years
- •Third year residents with two years of residency in internal medicine or family practice
- •Do not have to be currently practicing
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Amount of Time to Complete Assessment and Plan
Time Frame: 10 minutes
Each participant had 10 minutes maximum to review the patient case and write an Assessment and Plan.
Accuracy of Written Assessment and Plan in Terms of Control and Status
Time Frame: 10 minutes
Each participant had 10 minutes maximum to review the patient case and write an Assessment and Plan. The primary outcome evaluated participants' recommendations for treatment of patient conditions. Participants reviewed a total of 10 patient cases and received a score between 0 and 3 points for each issue within each patient case. The final score for each participant was a proportion between 0 and 1. The proportion represented the sum of all points assigned to the participant, divided by the total number of points possible. Higher values on the scale represent greater accuracy of the written assessment and plan.
Secondary Outcomes
- Identification of Planned Monitoring and Follow up Encounters in Assessment and Plan(10 minutes)