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Project Details - Ended
- Grant Number:R18 HS022767
- Funding Mechanism:
- AHRQ Funded Amount:$476,189
- Principal Investigator:
- Organization:
- Location:
- Project Dates:9/30/2013 to 12/31/2014
Project Categories
- Technology:
- Care Setting:
- Medical Condition:
- Population:
- Type of Care:
Summary:
This is one of twelve projects funded by the Agency for Healthcare Research and Quality (AHRQ) to inform Stage 3 Meaningful Use (MU) requirements through evidence. Clinical decision support (CDS) systems have the potential to improve quality if implemented correctly. The CDS Five Rights framework stipulates that CDS systems should be designed so that the right information is available to the right person, in the right CDS intervention format, through the right channel, at the right time in the workflow.
This project will assess the effectiveness of applying the CDS Five Rights framework to support the successful implementation of stage 3 MU CDS objectives. In addition, it will determine practice-level factors associated with implementation success. Factors such as practice size, setting, density of patients with the condition of focus, and quality improvement infrastructure will be evaluated.
The specific aims of this project are to:
- Determine the practice-level factors associated with successful implementation of the proposed MU Stage 3 clinical decision support objective for two high priority health conditions—cardiovascular disease prevention and asthma management—across a national network of federally qualified health centers.
- Determine the effects of contextual factors, such as a practice’s quality improvement infrastructure and history of innovation, on the level of support needed (CDS implementation framework with or without practice coaching) to achieve high rates of CDS use and integration into clinical workflow.
The first aim will be accomplished through a prospective observational study, conducted within a national network of federally qualified health centers. To achieve the second aim, a subset of federally qualified health centers will be randomized to implement the CDS Five Rights framework with or without practice coaching support. Sites randomized to the practice coaching support arm will receive bi-monthly training and support from a practice coach with experience in CDS implementation and quality improvement.
The lessons learned from this research will help to develop health information technology systems, such as electronic health records or personal health records, which help doctors, nurses, patients, and other members of health care teams to provide high-quality care. This project will fill critical knowledge gaps to inform MU policy and practice implementation.
