Understanding keys to successful implementation of electronic decision support in rural hospitals: analysis of a pilot study for antimicrobial prescribing

• HIT Description: Decision support More info...
  
• Purpose of Study: evaluate the impact of an internet-based clinical DSS on empiric antimicrobial prescribing for community acquired pneumonia in rural hospitals in Idaho
  
• Years of study: 2001-2002
  
• Study Design: pre-post
  
• Outcomes: impact of health care effectiveness and quality
  

• Settings: Patients with community-acquired pneumonia admitted to five rural hospitals in Idado that were involved in a local rural health network
• Intervention: For the baseline comparison data, clinical data was obtained by chart review and entered into the Antibiotic Assistant and empiric antibiotic recommendations were obtained and compared with actual historical prescribing. For the intervention, an antimicrobial management team (AMT) entered the data and provided real-time recommendations with providers within 24 hours of admission
• Evaluation Method: medical chart review, Antibiotic Assistant output
• Description: Antibiotic Assistant (Theradoc, Inc) is a therapeutic DSS that provides patient-specific antimicrobial recommendations based on patient characteristics and results of microbiology studies and was available as an internet-based platform for this study
• Barriers: providers were unwilling to enter data directly in the Antibiotic Assistant because of perceived time requirements so each hospital was asked to organize an AMT to enter data
• Quality of Care and Patient Safety Outcome: There was a significant improvement in agreement with all treatment recommendations and agreement with recommended dose or antimicrobial agent subsequent to the intervention, but this improvement was primarily accounted for by the performance of one hospital