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An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia

Electronic health record (EHR)-based clinical decision support (CDS) can address the low awareness and undertreatment of familial hypercholesterolemia (FH), a disorder associated with a markedly increased risk of coronary heart disease. We aimed to incorporate provider perspectives into the developm...

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Autores principales: Bangash, Hana, Pencille, Laurie, Gundelach, Justin H., Makkawy, Ahmed, Sutton, Joseph, Makkawy, Lenae, Dikilitas, Ozan, Kopecky, Stephen, Freimuth, Robert, Caraballo, Pedro J., Kullo, Iftikhar J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565418/
https://www.ncbi.nlm.nih.gov/pubmed/32717811
http://dx.doi.org/10.3390/jpm10030067
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author Bangash, Hana
Pencille, Laurie
Gundelach, Justin H.
Makkawy, Ahmed
Sutton, Joseph
Makkawy, Lenae
Dikilitas, Ozan
Kopecky, Stephen
Freimuth, Robert
Caraballo, Pedro J.
Kullo, Iftikhar J.
author_facet Bangash, Hana
Pencille, Laurie
Gundelach, Justin H.
Makkawy, Ahmed
Sutton, Joseph
Makkawy, Lenae
Dikilitas, Ozan
Kopecky, Stephen
Freimuth, Robert
Caraballo, Pedro J.
Kullo, Iftikhar J.
author_sort Bangash, Hana
collection PubMed
description Electronic health record (EHR)-based clinical decision support (CDS) can address the low awareness and undertreatment of familial hypercholesterolemia (FH), a disorder associated with a markedly increased risk of coronary heart disease. We aimed to incorporate provider perspectives into the development and implementation of a CDS tool for FH. An implementation science framework and a user-centered design process were used to create a CDS tool for FH. Primary care physicians and specialist physicians participated in qualitative interviews, usability testing and an implementation survey. The CDS was configured in two formats—a best practice alert (BPA) and an in-basket message and subsequently deployed in the EHR in silent mode. The key themes that emerged from the analysis of interview transcripts included understanding and awareness of FH, clinical workflow, physician preferences and value of CDS tools, perspectives on patient needs and values and dissemination and implementation. Recommendations related to usability included preferred CDS format and placement, content, timing and frequency, and level of alert urgency/prioritization. In response to the survey, 84.6% of physicians agreed that the CDS would improve early FH diagnosis and 92.3% agreed that it would help them identify and manage FH patients. Physician feedback led to iterative CDS refinement. In summary, we developed a CDS tool for FH using an implementation science framework and physician feedback. Initial deployment revealed a significant burden of FH and the potential for the CDS tool to have a large impact.
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spelling pubmed-75654182020-10-26 An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia Bangash, Hana Pencille, Laurie Gundelach, Justin H. Makkawy, Ahmed Sutton, Joseph Makkawy, Lenae Dikilitas, Ozan Kopecky, Stephen Freimuth, Robert Caraballo, Pedro J. Kullo, Iftikhar J. J Pers Med Article Electronic health record (EHR)-based clinical decision support (CDS) can address the low awareness and undertreatment of familial hypercholesterolemia (FH), a disorder associated with a markedly increased risk of coronary heart disease. We aimed to incorporate provider perspectives into the development and implementation of a CDS tool for FH. An implementation science framework and a user-centered design process were used to create a CDS tool for FH. Primary care physicians and specialist physicians participated in qualitative interviews, usability testing and an implementation survey. The CDS was configured in two formats—a best practice alert (BPA) and an in-basket message and subsequently deployed in the EHR in silent mode. The key themes that emerged from the analysis of interview transcripts included understanding and awareness of FH, clinical workflow, physician preferences and value of CDS tools, perspectives on patient needs and values and dissemination and implementation. Recommendations related to usability included preferred CDS format and placement, content, timing and frequency, and level of alert urgency/prioritization. In response to the survey, 84.6% of physicians agreed that the CDS would improve early FH diagnosis and 92.3% agreed that it would help them identify and manage FH patients. Physician feedback led to iterative CDS refinement. In summary, we developed a CDS tool for FH using an implementation science framework and physician feedback. Initial deployment revealed a significant burden of FH and the potential for the CDS tool to have a large impact. MDPI 2020-07-23 /pmc/articles/PMC7565418/ /pubmed/32717811 http://dx.doi.org/10.3390/jpm10030067 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bangash, Hana
Pencille, Laurie
Gundelach, Justin H.
Makkawy, Ahmed
Sutton, Joseph
Makkawy, Lenae
Dikilitas, Ozan
Kopecky, Stephen
Freimuth, Robert
Caraballo, Pedro J.
Kullo, Iftikhar J.
An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
title An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
title_full An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
title_fullStr An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
title_full_unstemmed An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
title_short An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
title_sort implementation science framework to develop a clinical decision support tool for familial hypercholesterolemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7565418/
https://www.ncbi.nlm.nih.gov/pubmed/32717811
http://dx.doi.org/10.3390/jpm10030067
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