Evaluation of an automated test ordering and feedback system for general practitioners in daily practice

Bindels, Rianne; Hasman, Arie; Wersch, J. W. J. Van; Talmon, Jan L.; Winkens, Ron

doi:10.1016/j.ijmedinf.2004.06.001

Cited by 13 publications

(5 citation statements)

References 29 publications

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“…As an alternative strategy for the present intervention, electronic reminders which have usually been thought to improve the quality of work [6][7][8][9] might be applied. Although electronic reminders are effective and useful, GPs ' compliance to use them is not necessary always high for various reasons [18]. Thereby, other methods may also enhance the use of modified laboratory test order forms or electronic reminders as a tool for improving the quality of care when applied simultaneously.…”

Section: Discussionmentioning

confidence: 99%

Altering a computerized laboratory test order form rationalizes ordering of laboratory tests in primary care physicians

Seppänen

Kauppila

Pitkälä

et al. 2016

International Journal of Medical Informatics

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Section: Discussionmentioning

confidence: 99%

Altering a computerized laboratory test order form rationalizes ordering of laboratory tests in primary care physicians

Seppänen

Kauppila

Pitkälä

et al. 2016

International Journal of Medical Informatics

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“…NHGDoc is developed for a generic setting and integrates multiple alerts within multiple domains of care or disease areas. Although CDSSs have proven to be successful in focusing on specific behaviors within well-defined areas of care, very little is known [ 36 , 37 ] on how systems designed for and used in a generic primary care setting will function. This trial will shed some light on this issue.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the uptake and effects of the computerized decision support system NHGDoc on quality of primary care: protocol for a large-scale cluster randomized controlled trial

Lugtenberg¹,

Westert²,

Pasveer³

et al. 2014

Implementation Sci

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BackgroundComputerized decision support systems (CDSSs) are increasingly used to improve quality of care. There is evidence for moderate to large effects from randomized controlled trials (RCTs), but evidence on their effectiveness when implemented at a national level is lacking. In the Netherlands, the Dutch College of General Practitioners (NHG) initiated their successful guideline program already 30 years ago. NHGDoc, a CDSS based on these NHG guidelines, covering multiple disease areas for general practice, was developed in 2006 with the aim to improve quality of primary care. In this paper, a protocol is presented to evaluate the uptake and effects of NHGDoc.MethodsA cluster RCT will be conducted among 120 general practices in the Netherlands. Eligible general practices will be randomized to receive either the regular NHGDoc decision support modules (control arm) or the regular modules plus an additional module on heart failure (intervention arm). The heart failure module consists of patient-specific alerts concerning the treatment of patients with heart failure. The effect evaluation will focus on performance indicators (e.g., prescription behavior) as well as on patient outcomes (e.g., hospital admissions) relevant in the domain of heart failure. Additionally, a process evaluation will be conducted to gain insight into the barriers and facilitators that affect the uptake and impact of NHGDoc.DiscussionResults of this study will provide insight in the uptake and impact of a multiple-domain covering CDSS for primary care implemented by a national guideline organization to improve the quality of primary care. Whereas the trial focuses on a specific domain of care—heart failure—conclusions of this study will shed light on the functioning of CDSSs covering multiple disease areas for primary care, particularly as this study also explores the factors contributing to the system’s uptake and effectiveness.Trial registrationClinical trials NCT01773057Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0145-5) contains supplementary material, which is available to authorized users.

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“…Alerting on contraindicated medication also proved helpful for patients suffering from renal insuff iciency [74]. CPOE is expected to be better accepted by physicians if predef ined problem-specific order lists appropriate for a given clinical situation or suggestions for alternate tests are presented to them [75][76]. Nevertheless, physician adoption of decision support remains a difficult task and wide variability in adoption and usage of these systems is reported [44,[77][78][79][80][81].…”

Section: Computerized Physician Order Entrymentioning

confidence: 99%

Section 2: Patient Records: The Computerized Patient Record: Where Do We Stand?

Jaspers¹,

Knaup²,

Schmidt³

2006

Yearb Med Inform

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SummaryTo provide an overview of trends in research, developments and implementations of the computerized patient record (CPR) of the last two years.We surveyed the medical informatics literature, spanning the years 2004-2005, focusing on publications on CPRs.The main trends revealed were: 1) the development of technologies to realize privacy and security goals or remote data entry and access to CPRs; 2) investigations into how to enhance the quality and reuse of CPR data; 3) the development and evaluation of decision support functions to be integrated with CPRs; 4) evaluations of the impact of CPRs on clinicians, patients, clinical work settings and patient outcomes; and 5) the further development and use of standards to move towards shared electronic health records (EHRs).The CPR is playing a growing part in medical informatics research and evaluation studies, but the goal of establishing a comprehensive lifelong EHR is still a long way off. In moving forward to EHRs, convergence of EHR standards seems required to realize true interoperability of health care applications. User acceptance of present-day CPRs (for all categories of users) and compatibility with work patterns has not been achieved yet, and can only be realized by giving these goals high priority. This will require substantial resources for in-depth work flow analysis, development and evaluation of CPRs. Besides this, the implementation of effective CPRs asks for health care organizations that are willing to invest in new developments and to contribute to evaluation studies, to further improve CPRs’ functionalities and enhance their use in practice.Haux R, Kulikowski C, editors. IMIA Yearbook of Medical Informatics 2006.

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Evaluation of an automated test ordering and feedback system for general practitioners in daily practice

Cited by 13 publications

References 29 publications

Altering a computerized laboratory test order form rationalizes ordering of laboratory tests in primary care physicians

Altering a computerized laboratory test order form rationalizes ordering of laboratory tests in primary care physicians

Evaluating the uptake and effects of the computerized decision support system NHGDoc on quality of primary care: protocol for a large-scale cluster randomized controlled trial

Section 2: Patient Records: The Computerized Patient Record: Where Do We Stand?

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