scholarly journals Impact of an Evidence-Based Computerized Decision Support System on Primary Care Prescription Costs

2004 ◽  
Vol 2 (5) ◽  
pp. 494-498 ◽  
Author(s):  
S. T. McMullin
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Evidence Based ◽  
Computerized Decision Support ◽  
Prescription Costs

A computerized decision support system (CDSS) for antibiotic prescription in primary care—Antibioclic: implementation, adoption and sustainable use in the era of extended antimicrobial resistance

2020 ◽  
Author(s):  
Tristan Delory ◽  
Pauline Jeanmougin ◽  
Sylvie Lariven ◽  
Jean-Pierre Aubert ◽  
Nathan Peiffer-Smadja ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Antibiotic Prescription ◽  
Sustainable Use ◽  
Acute Otitis Media ◽  
Community Acquired Pneumonia ◽  
Computerized Decision Support ◽  
Cross Sectional

Abstract Objectives To describe the implementation and use of a computerized decision support system (CDSS) for antibiotic prescription in primary care in France (Antibioclic). The CDSS targets 37 infectious diseases and has been freely available on a website since 2011. Methods Description and implementation of the architecture of a CDSS for antibiotic prescription in general practice. Analysis of the queries made between 2012 and 2018 on the CDSS by GPs. Analysis of two cross-sectional studies of users in 2014 and 2019. Results The number of queries increased from a median of 796/day [IQR, 578–989] in 2012 to 11 125/day [5592–12 505] in 2018. Unique users increased from 414/day [245–494] in 2012 to 5365/day [2891–5769] in 2018. Time taken to make a query was 2 min [1.9–2.1]. Among 3 542 347 queries in 2018, 78% were for adults. Six situations accounted for ≥50% of queries: cystitis; acute otitis media; acute sinusitis; community-acquired pneumonia; sore throat; and pyelonephritis. Queries concerned pathologies for which antibiotic prescription was necessary (64%), was conditional on additional clinical steps (34%) or was not recommended (2%). Most users (81%) were GPs, with median age of 38 years [31–52] and 58% were female. Among the 4016 GPs who responded to the surveys, the vast majority (96%) reported using the CDSS during the consultation, with 24% systematically using Antibioclic to initiate an antibiotic course and 93% having followed the CDSS recommendation for the latest prescription. Most GPs were comfortable using the CDSS in front of a patient. Conclusions Antibioclic has been adopted and is widely used in primary care in France. Its interoperability could allow its adaptation and implementation in other countries.

scholarly journals A Computerized Decision Support System for Depression in Primary Care

2009 ◽  
Vol 11 (4) ◽  
pp. 140-146 ◽  
Author(s):  
Benji T. Kurian ◽  
Madhukar H. Trivedi ◽  
Bruce D. Grannemann ◽  
Cynthia A. Claassen ◽  
Ella J. Daly ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Decision Support System ◽  
Support System ◽  
Computerized Decision Support

scholarly journals Development and implementation of a decision support system to improve control of hypertension and diabetes in a resource-constrained area in Brazil (Preprint)

2020 ◽  
Author(s):  
Milena Soriano Marcolino ◽  
João Antonio Queiroz Oliveira ◽  
Christiane Corrêa Rodrigues Cimini ◽  
Junia Xavier Maia ◽  
Vânia Soares Oliveira Almeida Pinto ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Decision Support System ◽  
Focus Groups ◽  
Support System ◽  
Low Income ◽  
User Satisfaction ◽  
Evidence Based ◽  
Resource Constrained ◽  
Decision Algorithm

BACKGROUND The low levels of control of hypertension and diabetes mellitus are a challenge that requires innovative strategies to surpass barriers of low sources, distance and quality of healthcare. OBJECTIVE To develop a clinical decision support system (CDSS) for diabetes and hypertension management in primary care, to implement it in a resource-constrained region, and to evaluate its usability and healthcare practitioner satisfaction. METHODS This mixed-methods study is a substudy of HealthRise Brazil Project, a multinational study designed to implement pilot programs to improve screening, diagnosis, management, and control of hypertension and diabetes among underserved communities. Following the identification of gaps in usual care, a team of clinicians established the software functional requirements. Recommendations from evidence-based guidelines were reviewed and organized into a decision algorithm, which bases the CDSS reminders and suggestions. Following pre-testing and expert panel assessment, pilot testing was conducted in a quasi-experimental study, which included 34 primary care units of ten municipalities in a resource-constrained area in Brazil. A Likert-scale questionnaire evaluating perceived feasibility, usability and utility of the application and professionals’ satisfaction was applied after six months. In the end line assessment, two focus groups with primary care physicians and nurses were performed. RESULTS A total of 159 reminders and suggestions were created and implemented for the CDSS. At the six-month assessment, there were 1939 patients registered in the application database and 2160 consultations were performed by primary care teams. Of the 96 healthcare professionals who were invited for the usability assessment, 26.0% were physicians, 45.8% were nurses and 28.1% were from other health professionals. The questionnaire composed of 24 items about impressions of feasibility, usability, utility and satisfaction, presented global Cronbach's alpha of 0.93. As for feasibility, all professionals agreed (median scores from 4 to 5) that the application could be used in primary care settings and it could be easily incorporated in work routines, but physicians claimed that the application might have caused significant delays in daily routines. As for usability, overall evaluation was good and it was claimed that the application was easy to understand and use. All professionals agreed that the application was useful (score 4-5) to promote prevention, assist to treatment and might improve patient care, and they were overall satisfied with the application (median scores between 4 and 5). In the end line assessment, there were 4211 patients (94.8% with hypertension and 24.4% with diabetes) registered in the application’s database and 7960 consultations were performed by primary healthcare teams. The 17 participants of the focus groups were consistent to affirm (what?) they were very satisfied with the CDSS. CONCLUSIONS The CDSS was applicable in the context of primary health care settings in low-income regions, with good user satisfaction and potential to improve adherence to evidence-based practices. CLINICALTRIAL

Developing an Evidence-Based Clinical Decision-Support System to Enhance Prosthetic Prescription

2021 ◽  
Vol 10 (1) ◽  
pp. 121-125
Author(s):  
Pratima Saravanan ◽  
Jessica Menold
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Support System ◽  
Gait Analysis ◽  
Support System ◽  
Patient Specific ◽  
Evidence Based ◽  
Extensive Literature ◽  
Analysis Tool ◽  
Care Providers

With the rapid increase in the global amputee population, there is a clear need to assist amputee care providers with their decision-making during the prosthetic prescription process. To achieve this, an evidence-based decision support system that encompasses existing literature, current decision-making strategies employed by amputee care providers and patient-specific factors is proposed. Based on an extensive literature review combined with natural language processing and expert survey, the factors influencing the current decision-making of amputee care providers in prosthetic prescription were identified. Following that, the decision-making strategies employed by expert and novice prosthetists were captured and analyzed. Finally, a fundamental understanding of the effect gait analysis has on the decision-making strategies of prosthetists was studied. Findings from this work lay the foundation for developing a real-time decision support system integrated with a portable gait analysis tool to enhance prescription processes. This is critical in the low-income countries where there is a scarcity of amputee care providers and resources for an appropriate prescription.

859-P: Impact of a Prediabetes Clinical Decision Support System on CV Risk Factor Control in Primary Care: Randomized Trial

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 859-P
Author(s):  
JAY R. DESAI ◽  
A. LAUREN CRAIN ◽  
DANIEL SAMAN ◽  
JOANN M. SPERL-HILLEN ◽  
CLAYTON ALLEN ◽  
...  
Keyword(s):  
Primary Care ◽  
Risk Factor ◽  
Decision Support ◽  
Decision Support System ◽  
Randomized Trial ◽  
Clinical Decision Support ◽  
Support System ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Risk Factor Control
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