| Development of an electronic medical record-based clinical decision support tool to improve HIV symptom management. | |
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MedLine Citation:
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PMID: 19538046 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Common symptoms associated with HIV disease and its management are often underrecognized and undertreated. A clinical decision support tool for symptom management was developed within the Veterans Health Administration electronic medical record (EMR), aiming at increasing provider awareness of and response to common HIV symptoms. Its feasibility was studied in March to May 2007 by implementing it within a weekly HIV clinic, comparing a 4-week intervention period with a 4-week control period. Fifty-six patients and their providers participated in the study. Patients' perceptions of providers' awareness of their symptoms, proportion of progress notes mentioning any symptom(s) and proportion of care plans mentioning any symptom(s) were measured. The clinical decision support tool used portable electronic "tablets" to elicit symptom information at the time of check-in, filtered, and organized that information into a concise and clinically relevant EMR note available at the point of care, and facilitated clinical responses to that information. It appeared to be well accepted by patients and providers and did not substantially impact workflow. Although this pilot study was not powered to detect effectiveness, 25 (93%) patients in the intervention group reported that their providers were very aware of their symptoms versus 27 (75%) control patients (p = 0.07). The proportion of providers' notes listing symptoms was similar in both periods; however, there was a trend toward including a greater number of symptoms in intervention period progress notes. The symptom support tool seemed to be useful in clinical HIV care. The Veterans Health Administration EMR may be an effective "laboratory" for developing and testing decision supports. |
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Authors:
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Claudia M Nader; Joel Tsevat; Amy C Justice; Joseph M Mrus; Forrest Levin; Michael J Kozal; Kristin Mattocks; Steven Farber; Michelle Rogers; Joseph Erdos; Cynthia Brandt; Ian Kudel; Ronald Braithwaite |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: AIDS patient care and STDs Volume: 23 ISSN: 1557-7449 ISO Abbreviation: AIDS Patient Care STDS Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-22 Completed Date: 2009-10-01 Revised Date: 2011-07-26 |
Medline Journal Info:
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Nlm Unique ID: 9607225 Medline TA: AIDS Patient Care STDS Country: United States |
Other Details:
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Languages: eng Pagination: 521-9 Citation Subset: IM; X |
Affiliation:
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Department of Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA. clnader@bu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Decision Making, Computer-Assisted Decision Support Systems, Clinical / instrumentation* Female HIV Infections / diagnosis*, drug therapy Humans Male Medical Records Systems, Computerized / instrumentation* Middle Aged Patient Satisfaction Physician's Practice Patterns Pilot Projects Practice Guidelines as Topic Questionnaires Severity of Illness Index* United States United States Department of Veterans Affairs |
| Grant Support | |
ID/Acronym/Agency:
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U10 AA013566-08/AA/NIAAA NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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