Uptake and Impact of a Clinical Diagnostic Decision Support Tool at an Academic Medical Center
John S. Barbieri, Benjamin French, Craig A. Umscheid
In Diagnosis, John Barbieri, Benjamin French and Craig Umscheid investigate whether the use of a differential diagnosis (DDX) generator within a health care system leads to an increase in unnecessary testing and specialty consultation. By providing access to a broad differential, DDX generators can potentially help clinicians overcome cognitive biases by directing them to diagnoses they might not have considered otherwise. However, as the tool suggests numerous potential diagnoses, its use could result in an increase in unnecessary testing and specialty consultation, and...
Adoption of Electronic Medical Record-Based Decision Support for Otitis Media in Children
Alexander G. Fiks, Peixin Zhang, A. Russell Localio, Saira Khan, Robert W. Grundmeier, Dean J. Karavite, Charles Bailey, Evaline A. Alessandrini, Christopher B. Forrest
In Health Services Research, Alexander Fiks and colleagues, including Christopher Forrest, analyze the impact of feedback in improving adoption of clinical decision support (CDS). The work is part of a larger trial of the effectiveness of CDS for diagnosing and treating ear infections in children. While substantial investment in electronic health records (EHRs) has provided an unprecedented opportunity to use CDS, the impact of feedback on clinician use of CDS systems has not been well studied. The authors looked at EHR-based CDS adoption during 41,391 ear infection visits, and...
The Use of Health Information Technology to Improve Care and Outcomes for Older Adults
Kathryn H. Bowles, Patricia Dykes, George Demiris
In a commentary in Research in Gerontological Nursing, Kathryn Bowles and colleagues look at how nurse scientists are using health information technology, such as electronic health records (EHR) and decision support, to improve care. They highlight positive research findings, including that integrated EHR systems reduced hospital-acquired pressure ulcers by 13 percent. Or how the use of a discharge decision support system helped to identify whether older adults were likely to need post-acute services, such as skilled home care or skilled nursing facility care. Use of the system,...
Digital Marketing to Physicians: Policy Lags Behind Practice
In a Perspective in today’s New England Journal of Medicine, David Grande, LDI's Co-Director of Health Policy, and colleagues write about new digital forms of pharmaceutical and medical device marketing to physicians. The same technologies that can be used to support clinical practice—such as electronic health records, social media, and mobile applications—can also be used to conduct market research and to market directly to physicians. Grande and colleagues write:
What do Edward Snowden and Daniel Ellsberg tell us about the appropriate use of personal health information?
Since Edward Snowden revealed that US agencies have been following social media, telephone data, and other seemingly private communications of US citizens, public reaction to his actions has been mixed. Roughly as many call him a traitor as call him a hero, and some simultaneously criticize his approaches and praise him for what he revealed.
VIDEO EXCERPT: Farzad Mostashari's Talk at LDI Health Policy Seminar
On the Way to Health
This Issue Brief describes the development and use of a new web-based IT platform, Way to Health, to deliver and evaluate behavioral interventions to improve health.
Evaluating Health Information Technology’s Clinical Effects
This Issue Brief reports on the experience of one hospital system that used its CPOE to reduce the incidence of a serious drug interaction. This rigorous test of a specific CPOE intervention shows that an electronic alert system can be effective in changing prescribing, but may also have unintended consequences for patient safety.
Computerized Physician Order Entry Systems: The Right Prescription?
This Issue Brief summarizes research that sounds a cautionary note about the potential for computerized systems to facilitate medication errors, as well as reduce them.