Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: The CODES study protocol for a randomized controlled trial

Lorenzo Moja, Hernan Polo Friz, Matteo Capobussi, Koren Kwag, Rita Banzi, Francesca Ruggiero, Marien González-Lorenzo, Elisa Giulia Liberati, Massimo Mangia, Peter Nyberg, Ilkka Kunnamo, Claudio Cimminiello, Giuseppe Vighi, Jeremy Grimshaw, Stefanos Bonovas

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge. Methods/design: We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period. Discussion: The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES). Trial registration: ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT02577198?term=NCT02577198&rank=1

Original languageEnglish
Article number89
JournalImplementation Science
Volume11
Issue number1
DOIs
Publication statusPublished - Jul 7 2016

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General Hospitals
Patient Care
Randomized Controlled Trials
Point-of-Care Systems
Quality of Health Care
Venous Thromboembolism
Delivery of Health Care
Length of Stay
Software
Clinical Decision Support Systems
Technology
Medical Informatics
Electronic Health Records
Health Services Research
Internal Medicine
Information Systems
Primary Health Care
Guidelines
Physicians
Mortality

Keywords

  • Computerized decision support systems
  • Electronic health records
  • Evidence-based medicine
  • Pragmatic trial
  • Randomized controlled trial
  • Reminder systems

ASJC Scopus subject areas

  • Health Policy
  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Health Informatics

Cite this

Implementing an evidence-based computerized decision support system to improve patient care in a general hospital : The CODES study protocol for a randomized controlled trial. / Moja, Lorenzo; Polo Friz, Hernan; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; González-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos.

In: Implementation Science, Vol. 11, No. 1, 89, 07.07.2016.

Research output: Contribution to journalArticle

Moja, L, Polo Friz, H, Capobussi, M, Kwag, K, Banzi, R, Ruggiero, F, González-Lorenzo, M, Liberati, EG, Mangia, M, Nyberg, P, Kunnamo, I, Cimminiello, C, Vighi, G, Grimshaw, J & Bonovas, S 2016, 'Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: The CODES study protocol for a randomized controlled trial', Implementation Science, vol. 11, no. 1, 89. https://doi.org/10.1186/s13012-016-0455-x
Moja, Lorenzo ; Polo Friz, Hernan ; Capobussi, Matteo ; Kwag, Koren ; Banzi, Rita ; Ruggiero, Francesca ; González-Lorenzo, Marien ; Liberati, Elisa Giulia ; Mangia, Massimo ; Nyberg, Peter ; Kunnamo, Ilkka ; Cimminiello, Claudio ; Vighi, Giuseppe ; Grimshaw, Jeremy ; Bonovas, Stefanos. / Implementing an evidence-based computerized decision support system to improve patient care in a general hospital : The CODES study protocol for a randomized controlled trial. In: Implementation Science. 2016 ; Vol. 11, No. 1.
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