English-based Pediatric Emergency Medicine Software Improves Physician Test Performance on Common Pediatric Emergencies: A Multicenter Study in Vietnam

Abstract

Introduction:Global health agencies and the Vietnam Ministry of Health have identified pediatric emergency care and health information technology as high priority goals. Clinical decision support (CDS) software provides physicians with access to current literature to answer clinical queries, but there is limited impact data in developing countries. We hypothesized that Vietnamese physicians will demonstrate improved test performance on common pediatric emergencies using CDS technologies despite being in English.Methods:This multicenter, prospective, pretest-posttest study was conducted in 11 Vietnamese hospitals enrolled a convenience sample of physicians who attended an 80-minute software training on a pediatric CDS software (PEMSoft). Two multiple-choice exams (A, B) were administered before and after the session. Participants, who received Test A as a pretest, received Test B as a posttest, and vice versa. Participants used the CDS software for the posttest. The primary outcome measure was the mean percentage difference in physician scores between the pretest and posttest, as calculated by a paired, two-tailed t-test.Results:For the 203 participants, the mean pretest, posttest, and improvement scores were 37% (95% CI: 35–38%), 70% (95% CI: 68–72%), and 33% (95% CI: 30–36%), respectively, with p<0.0001. This represents an 89% improvement over baseline. Subgroup analysis of practice setting, clinical experience, and comfort level with written English and computers showed that all subgroups equivalently improved their test scores.Conclusion:After brief training, Vietnamese physicians can effectively use an English-based CDS software based on improved performance on a written clinical exam. Given this rapid improvement, CDS technologies may serve as a transformative tool in resource-poor environments.

Digital Health Policy and Programs for Hospital Care in Vietnam: Scoping Review

“…However, there was a lack of IT infrastructure, basic IT use among the hospital staff such as regular communication via email, and IT training capacity in place for EHR implementation. Lin et al [ 30 ] evaluated physicians’ performance on a multiple-choice exam with the support of a system (CDS system [CDSS]). The participants improved their exam performance when using the CDS software compared with when not using the CDS software.…”

Segmenting Clinicians’ Usage Patterns of a Digital Health Tool in Resource-Limited Settings: Clickstream Data Analysis and Survey Study

“…Recent research from the United States demonstrates that the use of UpToDate, a leading commercial EBCR, increased clinicians’ performance on standardized exams and reduced patients’ average length of stay and risk-adjusted mortality rates at nonteaching hospitals [ 3 , 4 ]. Observational research from several low-income countries shows that the use of an EBCR is associated with either improved outcomes or process measures [ 5 - 7 ].…”

Segmenting Clinicians’ Usage Patterns of a Digital Health Tool in Resource-Limited Settings: Clickstream Data Analysis and Survey Study (Preprint)

“…Recent research from the United States demonstrates that the use of UpToDate, a leading commercial EBCR, increased clinicians' performance on standardized exams and reduced patients' average length of stay and risk-adjusted mortality rates at nonteaching hospitals [3,4]. Observational research from several low-income countries shows that the use of an EBCR is associated with either improved outcomes or process measures [5][6][7].…”