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Supporting Clinicians to Improve Decision Making and Patients’ Care - Emerging Research

Applying Digital Healthcare Solutions in Acute Settings

Emergency departments (EDs) deliver high-volume patient care in hazardous decision-making environments fraught with excessive cognitive loading and time pressure. Digital healthcare solutions in acute settings, such as CDS and artificial intelligence (AI) can support clinician decisions by exploiting large-scale EHR data to aid prognosis, extract signal from noise, and reduce variability in practice.

 

Drs. Jeremiah S. Hinson and Scott R. Levin of Johns Hopkins University are investigating the use of AI to provide CDS in the detection of acute kidney injury (AKI) in the ED setting. The research team will develop, pilot-test, and evaluate an AI-driven, EHR-based algorithm to estimate AKI risk and flag patients for CDS at three study sites. Successful development and implementation of this AI-driven CDS system for detection and treatment of acute kidney injury will improve the quality of kidney care and generate best-practice methods to advance the application of artificial intelligence and development of a scalable CDS product.

Read Drs. Hinson & Levin's Emerging Research Story

 

Improving Primary and Preventive Care with Evidence-Based Clinical Decision Support Systems

When well developed and implemented, CDS helps clinicians, patients, and others on the care team by delivering the right information at the right time, so the team can make the best care decisions. CDS can support primary care and tailor preventive care during time-constrained appointments. A snapshot of new AHRQ-funded CDS research focuses on preventive care that includes the following:

 

Dr. Marissa Burgermaster and a team of investigators at the University of Texas–Austin are studying the use of a CDS system to support collaborative diet goal setting for patients with obesity, particularly among populations experiencing health disparities. The research team is enhancing an existing CDS prototype, Diet Goal CDS, into a user-centered, EHR- and workflow-compatible CDS that analyzes diet history data and produces a tailored list of personalized diet goals. The enhanced tool will be evaluated to observe behavior change among patients and providers with the overall aim to reduce obesity in their patient population.

 

Building on past projects, evidence, and technology, a multi-institution research team led by Drs. Patricia Dykes and Robert J. Lucero of Brigham and Women’s Hospital and University of Florida, respectively, will develop a shareable, standards-based CDS tool for fall prevention. This tool will support primary care practices in their fall risk assessment and prevention care plans. Called the Advancing Fall Assessment and Prevention Patient-Centered Outcomes Research Findings into Diverse Primary Care Practices (ASPIRE) project, the research team will leverage multiple sourced evidence-based decision rules and previous clinical trials to inform the ASPIRE CDS and care plan collaboration tool. The tool will identify shareable community-based fall assessment and prevention CDS resources, available at the point of care, that support interoperable fall prevention CDS logic according to HL7 Clinical Quality Standards. The ASPIRE CDS will be tested and implemented in rural and urban primary care clinics, with the aims of embedding the tool seamlessly into clinical workflows while also scaling and disseminating it broadly for use by primary care providers.

 

Dr. Elyse Kharbanda at HealthPartners Institute and Dr. Catherine Benziger at Essentia Health are evaluating the effectiveness of a previously developed EHR-linked CDS tool, Peds & TeenBP, on screening and treatment of hypertension and high blood pressure among rural adolescents. The research team aims to advance the standard practice of blood pressure measurement, increase hypertension recognition, and promote guideline-adherent management of hypertension in rural youth.

Read Drs. Kharbanda & Benziger's Emerging Research Story

 

An Emory University research team led by Dr. Evan William Orenstein will develop a CDS system and test its usability, implementation, and impact on influenza vaccine uptake among children at three hospitals. Frontline staff, pharmacists, family advocates, and other stakeholders will be engaged in user-centered design to inform development of a CDS prototype, which will then be evaluated for vaccine uptake. The team hopes that the findings from this study will serve as a CDS model for other health maintenance interventions in pediatric acute care settings.