Emergency physicians' knowledge and attitudes of clinical decision support in the electronic health record: A survey-based study

Academic Emergency Medicine

Volumn 20, Issue 4, 2013, Pages 352-360

  Ballard, Dustin W ^a,b   Rauchwerger, Adina S ^a,c   Reed, Mary E ^a,c   Vinson, David R ^a,b   Mark, Dustin G ^a,b   Offerman, Steven R ^a,b   Chettipally, Uli K ^a,b   Graetz, Ilana ^a,c   Dayan, Peter ^d   Kuppermann, Nathan ^e  

^a KAISER PERMANENTE MEDICAL CENTER   (United States)

^b KAISER PERMANENTE   (United States)

^c DIVISION OF RESEARCH   (United States)

^d Och Spine at New York Presbyterian Hospitals   (United States)

^e UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ARTICLE; CHILD; CLINICAL ARTICLE; CLINICAL DECISION MAKING; CLINICAL EVALUATION; COMPUTER ASSISTED TOMOGRAPHY; CONTROLLED STUDY; DECISION SUPPORT SYSTEM; ELECTRONIC MEDICAL RECORD; EMERGENCY PHYSICIAN; FEMALE; HEAD INJURY; HEALTH SURVEY; HUMAN; INTEGRATED HEALTH CARE SYSTEM; LOGISTIC REGRESSION ANALYSIS; MALE; PHYSICIAN ATTITUDE; PREDICTION; PRESCHOOL CHILD; PRIORITY JOURNAL; SCHOOL CHILD; SELF REPORT; VIGNETTE;

ADULT; ATTITUDE OF HEALTH PERSONNEL; CHILD; CRANIOCEREBRAL TRAUMA; DECISION SUPPORT SYSTEMS, CLINICAL; ELECTRONIC HEALTH RECORDS; EMERGENCY SERVICE, HOSPITAL; EMERGENCY TREATMENT; FEMALE; GUIDELINE ADHERENCE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HUMANS; MALE; MIDDLE AGED; PEDIATRICS; POPULATION SURVEILLANCE; QUESTIONNAIRES; RANDOM ALLOCATION;

EID: 84876347289     PISSN: 10696563     EISSN: 15532712     Source Type: Journal    
DOI: 10.1111/acem.12109     Document Type: Article

References (56)

1. Centers for Medicare & Medicaid Services. EHR incentive programs. Available at: https://www.cms.gov/EHRIncentivePrograms/30-Meaningful-Use.asp. Accessed Dec 13, 2011.
2. American Recovery and Reinvestment Act USA, 2009.
3. Jha AK,. Meaningful use of electronic health records: the road ahead. JAMA. 2010; 304: 1709-10.
4. Stiell IG, Bennett C,. Implementation of clinical decision rules in the emergency department. Acad Emerg Med. 2007; 14: 955-9.
5. Eagles D, Stiell IG, Clement CM, et al. International survey of emergency physicians' awareness and use of the Canadian Cervical-Spine Rule and the Canadian Computed Tomography Head Rule. Acad Emerg Med. 2008; 15: 1256-61.
6. Stiell IG, McKnight RD, Greenberg GH, et al. Implementation of the Ottawa ankle rules. JAMA. 1994; 271: 827-32.
7. Graham ID, Stiell IG, Laupacis A, O'Connor AM, Wells GA,. Emergency physicians' attitudes toward and use of clinical decision rules for radiography. Acad Emerg Med. 1998; 5: 134-40.
8. Eagles D, Stiell IG, Clement CM, et al. International survey of emergency physicians' priorities for clinical decision rules. Acad Emerg Med. 2008; 15: 177-82.
9. Melnick ER, Nielson JA, Finnell JT, et al. Delphi consensus on the feasibility of translating the ACEP clinical policies into computerized clinical decision support. Ann Emerg Med. 2010; 56: 317-20.
10. Bates DW, Kuperman GJ, Wang S, et al. Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J Am Med Inform Assoc. 2003; 10: 523-30.
11. Kuppermann N,. Intracranial injury in minor head trauma. Arch Dis Child. 2004; 89: 593-4.
12. Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009; 374: 1160-70.
13. Brenner D, Elliston C, Hall E, Berdon W,. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol. 2001; 176: 289-96.
14. Brenner DJ,. Estimating cancer risks from pediatric CT: going from the qualitative to the quantitative. Pediatr Radiol. 2002; 32: 228-3.
15. Pickering A, Harnan S, Fitzgerald P, Pandor A, Goodacre S,. Clinical decision rules for children with minor head injury: a systematic review. Arch Dis Child. 2011; 96: 414-21.
16. Langlois J, Rutland-Brown W, Thomas K,. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths. Available at: http://www.cdc.gov/traumaticbraininjury/pdf/blue-book.pdf. Accessed Jan 14, 2013.
17. National Center for Injury Prevention and Control. Traumatic Brain Injury in the United States: Assessing Outcomes in Children. Available at: www.cdc.gov/traumaticbraininjury/assessing-outcomes-in-children.html. Accessed Jan 14, 2013.
18. Dunning J, Daly JP, Lomas JP, Lecky F, Batchelor J, Mackway-Jones K,. Derivation of the children's head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Arch Dis Child. 2006; 91: 885-91.
19. Homer CJ, Kleinman L,. Technical report: minor head injury in children. Pediatrics. 1999; 104: e78.
20. Blackwell CD, Gorelick M, Holmes JF, Bandyopadhyay S, Kuppermann N,. Pediatric head trauma: changes in use of computed tomography in emergency departments in the United States over time. Ann Emerg Med. 2007; 49: 320-4.
21. Schnadower D, Vazquez H, Lee J, Dayan P, Roskind CG,. Controversies in the evaluation and management of minor blunt head trauma in children. Curr Opin Pediatr. 2007; 19: 258-64.
22. MedPage Today. FDA Unveils New Safety Plan for Medical Imaging. Available at: http://www.medpagetoday.com/Radiology/DiagnosticRadiology/18398. Accessed Jan 14, 2013.
23. Lyttle MD, Crowe L, Oakley E, Dunning J, Babl FE,. Comparing CATCH, CHALICE and PECARN clinical decision rules for paediatric head injuries. Emerg Med J. 2012; 29: 785-94.
24. Klassen TP, Reed MH, Stiell IG, et al. Variation in utilization of computed tomography scanning for the investigation of minor head trauma in children: a Canadian experience. Acad Emerg Med. 2000; 7: 739-44.
25. Stiell IG, Wells GA, Vandemheen K, et al. Variation in emergency department use of cervical spine radiography for alert, stable trauma patients. CMAJ. 1997; 156: 1537-44.
26. Graham ID, Stiell IG, Laupacis A, et al. Awareness and use of the Ottawa ankle and knee rules in 5 countries: can publication alone be enough to change practice? Ann Emerg Med. 2001; 37: 259-66.
27. Reilly BM, Evans AT,. Translating clinical research into clinical practice: impact of using prediction rules to make decisions. Ann Intern Med. 2006; 144: 201-9.
28. Stiell IG, Wells GA,. Methodologic standards for the development of clinical decision rules in emergency medicine. Ann Emerg Med. 1999; 33: 437-47.
29. Grol R, Grimshaw J,. From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003; 362: 1225-30.
30. Anderson G,. Implementing practice guidelines. CMAJ. 1993; 148: 753-5.
31. Kawamoto K, Houlihan CA, Balas EA, Lobach DF,. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ. 2005; 330: 765.
32. Drescher FS, Chandrika S, Weir ID, et al. Effectiveness and acceptability of a computerized decision support system using modified Wells criteria for evaluation of suspected pulmonary embolism. Ann Emerg Med. 2011; 57: 613-21.
33. Roy PM, Durieux P, Gillaizeau F, et al. A computerized handheld decision-support system to improve pulmonary embolism diagnosis: a randomized trial. Ann Intern Med 2009; 151: 677-86.
34. Dillman D,. Mail and Telephone Surveys. The Total Design Method. New York, NY: Wiley Interscience, 1978.
35. Nigrovic LE, Schunk JE, Foerster A, et al. The effect of observation on cranial computed tomography utilization for children after blunt head trauma. Pediatrics. 2011; 127: 1067-73.
36. Palchak MJ, Holmes JF, Vance CW, et al. A decision rule for identifying children at low risk for brain injuries after blunt head trauma. Ann Emerg Med. 2003; 42: 492-506.
37. Boutis K, Constantine E, Schuh S, Pecaric M, Stephens D, Narayanan UG,. Pediatric emergency physician opinions on ankle radiograph clinical decision rules. Acad Emerg Med. 2010; 17: 709-17.
38. Morton MJ, Korley FK,. Head computed tomography use in the emergency department for mild traumatic brain injury: integrating evidence into practice for the resident physician. Ann Emerg Med. 2012; 60: 361-7.
39. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press, 2001.
40. Handel D, Wears R, Nathanson LA, Pines JM,. Using information technology to improve the quality and safety of emergency care. Acad Emerg Med. 2011; 18: e45-51.
41. Buntin MB, Burke MF, Hoaglin MC, Blumenthal D,. The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Aff (Millwood). 2011; 30: 464-71.
42. Bria WF,. The electronic health record: is it meaningful yet? Mayo Clin Proc. 2011; 86: 373-4.
43. McGowan JJ, Cusack CM, Bloomrosen M,. The future of health IT innovation and informatics: a report from AMIA's 2010 policy meeting. J Am Med Inform Assoc. 2012; 19: 460-7.
44. Han YY, Carcillo JA, Venkataraman ST, et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2005; 116: 1506-12.
45. Jones SS, Adams JL, Schneider EC, Ringel JS, McGlynn EA,. Electronic health record adoption and quality improvement in US hospitals. Am J Manag Care. 2010; 16 (12 Suppl HIT): SP64-71.
46. Liu JL, Wyatt JC,. The case for randomized controlled trials to assess the impact of clinical information systems. J Am Med Inform Assoc. 2011; 18: 173-80.
47. Rosenthal DI, Weilburg JB, Schultz T, et al. Radiology order entry with decision support: initial clinical experience. J Am Coll Radiol. 2006; 3: 799-806.
48. Sanders DL, Miller RA,. The effects on clinician ordering patterns of a computerized decision support system for neuroradiology imaging studies. Proc AMIA Symp. 2001: 583-7.
49. Bright TJ, Wong A, Dhurjati R, et al. Effect of clinical decision-support systems: a systematic review. Ann Intern Med. 2012; 157: 29-43.
50. Pandor A, Goodacre S, Harnan S, et al. Diagnostic management strategies for adults and children with minor head injury: a systematic review and an economic evaluation. Health Technol Assess. 2011; 15: 1-202.
51. Kastner M, Estey E, Perrier L, et al. Understanding the relationship between the perceived characteristics of clinical practice guidelines and their uptake: protocol for a realist review. Implement Sci. 2011; 6: 69.
52. Agency for Healthcare Research and Quality. Health Information Technology. Available at: http://healthit.ahrq.gov/portal/server.pt/community/ ahrq-national-resource-center-for-health-it/650. Accessed Jan 13, 2013.
53. Brehaut JC, Graham ID, Wood TJ, et al. Measuring acceptability of clinical decision rules: validation of the Ottawa acceptability of decision rules instrument (OADRI) in four countries. Med Decis Making. 2010; 30: 398-408.
54. Croskerry P, Abbass A, Wu AW,. Emotional influences in patient safety. J Patient Saf. 2010; 6: 199-205.
55. Croskerry P,. Diagnostic failure: a cognitive and affective approach. In:, Henriksen K, Battles JB, Marks ES, et al., editors. Advances in Patient Safety: From Research to implementation. Vol 2. Rockville, Maryland: Agency for Healthcare Research and Quality (US); 2005. pp. 241-54.
56. Hebert JR, Clemow L, Pbert L, Ockene IS, Ockene JK,. Social desirability bias in dietary self-report may compromise the validity of dietary intake measures. Int J Epidemiol. 1995; 24: 389-98.