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Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative
BACKGROUND: Participant recruitment, especially for frail, elderly, hospitalized patients, remains one of the greatest challenges for many research groups. Traditional recruitment methods such as chart reviews are often inefficient, low-yielding, time consuming, and expensive. Best Practice Alert (B...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658304/ https://www.ncbi.nlm.nih.gov/pubmed/31025947 http://dx.doi.org/10.2196/10020 |
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author | Devoe, Connor Gabbidon, Harriett Schussler, Nina Cortese, Lauren Caplan, Emily Gorman, Colin Jethwani, Kamal Kvedar, Joseph Agboola, Stephen |
author_facet | Devoe, Connor Gabbidon, Harriett Schussler, Nina Cortese, Lauren Caplan, Emily Gorman, Colin Jethwani, Kamal Kvedar, Joseph Agboola, Stephen |
author_sort | Devoe, Connor |
collection | PubMed |
description | BACKGROUND: Participant recruitment, especially for frail, elderly, hospitalized patients, remains one of the greatest challenges for many research groups. Traditional recruitment methods such as chart reviews are often inefficient, low-yielding, time consuming, and expensive. Best Practice Alert (BPA) systems have previously been used to improve clinical care and inform provider decision making, but the system has not been widely used in the setting of clinical research. OBJECTIVE: The primary objective of this quality-improvement initiative was to develop, implement, and refine a silent Best Practice Alert (sBPA) system that could maximize recruitment efficiency. METHODS: The captured duration of the screening sessions for both methods combined with the allotted research coordinator hours in the Emerald-COPD (chronic obstructive pulmonary disease) study budget enabled research coordinators to estimate the cost-efficiency. RESULTS: Prior to implementation, the sBPA system underwent three primary stages of development. Ultimately, the final iteration produced a system that provided similar results as the manual Epic Reporting Workbench method of screening. A total of 559 potential participants who met the basic prescreen criteria were identified through the two screening methods. Of those, 418 potential participants were identified by both methods simultaneously, 99 were identified only by the Epic Reporting Workbench Method, and 42 were identified only by the sBPA method. Of those identified by the Epic Reporting Workbench, only 12 (of 99, 12.12%) were considered eligible. Of those identified by the sBPA method, 30 (of 42, 71.43%) were considered eligible. Using a side-by-side comparison of the sBPA and the traditional Epic Reporting Workbench method of screening, the sBPA screening method was shown to be approximately four times faster than our previous screening method and estimated a projected 442.5 hours saved over the duration of the study. Additionally, since implementation, the sBPA system identified the equivalent of three additional potential participants per week. CONCLUSIONS: Automation of the recruitment process allowed us to identify potential participants in real time and find more potential participants who meet basic eligibility criteria. sBPA screening is a considerably faster method that allows for more efficient use of resources. This innovative and instrumental functionality can be modified to the needs of other research studies aiming to use the electronic medical records system for participant recruitment. |
format | Online Article Text |
id | pubmed-6658304 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-66583042019-07-31 Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative Devoe, Connor Gabbidon, Harriett Schussler, Nina Cortese, Lauren Caplan, Emily Gorman, Colin Jethwani, Kamal Kvedar, Joseph Agboola, Stephen JMIR Med Inform Original Paper BACKGROUND: Participant recruitment, especially for frail, elderly, hospitalized patients, remains one of the greatest challenges for many research groups. Traditional recruitment methods such as chart reviews are often inefficient, low-yielding, time consuming, and expensive. Best Practice Alert (BPA) systems have previously been used to improve clinical care and inform provider decision making, but the system has not been widely used in the setting of clinical research. OBJECTIVE: The primary objective of this quality-improvement initiative was to develop, implement, and refine a silent Best Practice Alert (sBPA) system that could maximize recruitment efficiency. METHODS: The captured duration of the screening sessions for both methods combined with the allotted research coordinator hours in the Emerald-COPD (chronic obstructive pulmonary disease) study budget enabled research coordinators to estimate the cost-efficiency. RESULTS: Prior to implementation, the sBPA system underwent three primary stages of development. Ultimately, the final iteration produced a system that provided similar results as the manual Epic Reporting Workbench method of screening. A total of 559 potential participants who met the basic prescreen criteria were identified through the two screening methods. Of those, 418 potential participants were identified by both methods simultaneously, 99 were identified only by the Epic Reporting Workbench Method, and 42 were identified only by the sBPA method. Of those identified by the Epic Reporting Workbench, only 12 (of 99, 12.12%) were considered eligible. Of those identified by the sBPA method, 30 (of 42, 71.43%) were considered eligible. Using a side-by-side comparison of the sBPA and the traditional Epic Reporting Workbench method of screening, the sBPA screening method was shown to be approximately four times faster than our previous screening method and estimated a projected 442.5 hours saved over the duration of the study. Additionally, since implementation, the sBPA system identified the equivalent of three additional potential participants per week. CONCLUSIONS: Automation of the recruitment process allowed us to identify potential participants in real time and find more potential participants who meet basic eligibility criteria. sBPA screening is a considerably faster method that allows for more efficient use of resources. This innovative and instrumental functionality can be modified to the needs of other research studies aiming to use the electronic medical records system for participant recruitment. JMIR Publications 2019-04-26 /pmc/articles/PMC6658304/ /pubmed/31025947 http://dx.doi.org/10.2196/10020 Text en ©Connor Devoe, Harriett Gabbidon, Nina Schussler, Lauren Cortese, Emily Caplan, Colin Gorman, Kamal Jethwani, Joseph Kvedar, Stephen Agboola. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 26.04.2019. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Medical Informatics, is properly cited. The complete bibliographic information, a link to the original publication on http://medinform.jmir.org/, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Devoe, Connor Gabbidon, Harriett Schussler, Nina Cortese, Lauren Caplan, Emily Gorman, Colin Jethwani, Kamal Kvedar, Joseph Agboola, Stephen Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative |
title | Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative |
title_full | Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative |
title_fullStr | Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative |
title_full_unstemmed | Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative |
title_short | Use of Electronic Health Records to Develop and Implement a Silent Best Practice Alert Notification System for Patient Recruitment in Clinical Research: Quality Improvement Initiative |
title_sort | use of electronic health records to develop and implement a silent best practice alert notification system for patient recruitment in clinical research: quality improvement initiative |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658304/ https://www.ncbi.nlm.nih.gov/pubmed/31025947 http://dx.doi.org/10.2196/10020 |
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