Can computer-generated evidence-based care suggestions enhance evidence-based management of asthma and chronic obstructive pulmonary disease? A randomized, controlled trial

• HIT Description: Guideline-based decision-support system More info...
  
• Purpose of Study: To determine whether guideline-based suggestions presented to physicians and pharmacists would improve the care of asthma and COPD
  
• Years of study: 1994-1996
  
• Study Design: RCT
  
• Outcomes: impact on patient satisfaction, health care effectiveness and quality, and efficiency, utilization and costs
  

• Settings: 4 hospital-based primary care practices (Indiana University Medical Group-Primary Care) with associated outpatient pharmacies. Patients were >18 with diagnosis of asthma or COPD based on diagnosis, medication or xray result
• Intervention: 2X2 factorial randomization of practice sessions and pharmacists so that physicians or pharmacists assigned to the intervention who were seeing intervention patients were presented with computerized and paper care suggestions or suggested orders.
• Evaluation Method: Surveys, chart abstraction, electronic medication data
• Description: care suggestion rules programmed into physicians' computer workstations
• Strategy: Intervention physicians required to view all care suggestions and both intervention and control physicians required to enter all orders electronically
• Barriers: physicians were skeptical of benefits and intentions of guidelines
• Quality of Care and Patient Safety Outcome: There were no differences between intervention and control groups in adherence to care suggestions, impact on quality of life, medication adherence or patient satisfaction
• Changes in healthcare costs: Negative impact with increased total health care charges for patients receiving only the physician intervention