Using a Clinical Decision Support Tool to Increase Chlamydia Screening Across a Large Primary Care Pediatric Network

Karas, David R.; Sondike, Stephen B.; Fitzgibbon, Jim; Redding, Mark; Brown, Miraides

doi:10.1177/0009922818803397

Cited by 13 publications

(13 citation statements)

References 8 publications

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“…Chadwick et al 16 created a standardized, computer-generated laboratory order sheet to reduce incomplete testing and changed their testing policy from “opt-in” to “opt-out.” This program led to an STI testing rate increase from 5.5% to 45.2%. In addition, Karas et al 25 implemented the use of an electronic health record–based clinical decision support tool to increase annual chlamydia screening in a primary care pediatric network. This system provided alerts for sexually active females presenting for well care visits who had not had an annual chlamydia screening.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of New Approaches to Sexually Transmitted Infection Screening Framed in the Capability, Opportunity, Motivation, and Behavior Model of Implementation Science

Footman¹,

Dagama²,

Smith

et al. 2021

Sexual Trans Dis

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Chlamydia and gonorrhea are 2 of the most common bacterial sexually transmitted infections (STIs) worldwide. Rising chlamydia and gonorrhea rates along with increased closing of STI clinics has led many to seek STI testing in clinical settings such as urgent cares and walk-in clinics. However, with competing priorities, providing effective and efficient STI care can be difficult in these settings. This has left a growing need for the implementation of novel STI screening programs in other clinical settings. This review summarizes previous studies that have evaluated the clinical implementation of chlamydia and gonorrhea screening programs in these settings. Literature from January 2015 to February 2020 regarding the implementation or evaluation of STI screening programs in clinical settings was reviewed. Constructs from the Capability, Opportunity, Motivation, and Behavior model were used to organize results, as this model can aid in identifying specific strategies for behavior/process change interventions. We found that multiple STI screening programs have been implemented and evaluated in 5 different countries and multiple health care facilities including sexual health clinics, urgent cares, walk-in clinics, and university health clinics. When implementing new STI screening programs, sample-first, test-and-go services and molecular point-of-care (POC) testing approaches were found to be effective in increasing screening and reducing costs and time to treatment. At the health care systems level, these programs can help reduce STI screening costs and generate additional revenue for clinics. At the provider level, clear communication and guidance can help clinical and administrative staff in adopting new screening programs. Finally, at the patient level, new programs can reduce time to treatment and travel costs in visiting clinics multiple times for testing and treatment services.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of New Approaches to Sexually Transmitted Infection Screening Framed in the Capability, Opportunity, Motivation, and Behavior Model of Implementation Science

Footman¹,

Dagama²,

Smith

et al. 2021

Sexual Trans Dis

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“… 28 Karas et al further demonstrated the impact of CDS in a pediatric primary care network by doubling the Chlamydia screening rates for at-risk patients. 29 McGrath et al reported the CDS impact on lead screening in primary care settings in a small study that utilized provider reminders to increase ordered screens from 21 to 49% but with less impact on actual testing results (17% baseline to 18% postintervention). 24 We believe our study demonstrates a more significant impact on lead screening in a larger primary care practice network.…”

Section: Discussionmentioning

confidence: 99%

Improving Lead Screening Rates in a Large Pediatric Primary Care Network

Davidson

Karas

Bigham

2021

Pediatric Quality &Amp; Safety

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Introduction: Exposure to environmental lead continues to be a significant public health concern. Elevated blood lead levels can lead to neurocognitive delays and other adverse health outcomes. Unfortunately, screening rates in most communities remain low. This quality improvement project aimed to improve universal screening at 12 months of age and increase screening rates from 71% to 95%. The project team also aimed to improve risk-based screening at 24 months of age to increase screening rates from 41% to 70%. Methods: This project utilized the Model for Improvement. After identifying key drivers, the team designed, tested, and adopted a series of interventions to improve lead screening. Dynamic order sets were developed that pre-checked the lead order, if appropriate, based on the patient’s age, previous results, and risk factors. Sites received regular feedback on their screening rates. Results: The percentage of patients receiving universal lead screening at their 12-month well visit increased from 71% to 96%. 70% of 2-year-olds were at risk for lead exposure based on ZIP code and insurance provider. Development of dynamic orders for patients at risk increased screening rates from 41% to 74% at the 24-month well visit. Conclusions: Utilization of clinical decision support tools within an electronic health record can significantly increase the percentage of children screened for lead toxicity. Similar tools could identify patients due for other screens or interventions, resulting in improved care and patient outcomes.

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“…Na primeira categoria, foram alocados artigos que relatavam estudos sobre diferentes tipos e aplicações de sistemas de apoio à decisão, que podem ser definidos como "processo para CAPÍTULO i aeaeaeaeaeaea melhorar as decisões e ações relacionadas à saúde, com conhecimento clínico organizado e informação para melhorar a saúde e a prestação de cuidados de saúde" (KARAS et al, 2018).…”

Section: Tipos Aplicações E Finalidades De Sistemas De Apoio à Decisãounclassified

“…Quanto ao tipo, os estudos incluem ferramentas do tipo software (Rubin et al, 2021;Thompson et al, 2021;McParland;Cooper;Johnston, 2019;Harry et al, 2022;KARAS et al, 2018), questionários avaliativos físicos (Mendonça et al, 2020) ou digitais (Lovgren et al, 2017), algoritmos de machine learning (Shimpi et al, 2019;Shimpi et al, 2022) e textos explicativos (Santos et al, 2022).…”

Section: Tipos Aplicações E Finalidades De Sistemas De Apoio à Decisãounclassified

“…No tocante à finalidade, a utilização de sistemas de apoio à decisão apresenta diversas possibilidades, desde o rastreamento do câncer (Harry et al, 2022;Santos et al, 2022;Thompson et al, 2021), passando avaliação de risco para neoplasia (Shimpi et al, 2022), avaliação de sintomas na atenção primária à saúde (Rubin et al, 2021), diagnóstico diferencial (McParland;Cooper;Johnston, 2019), caracterização da capacidade funcional de idosos (Mendonça et al, 2020), desfecho para desordem temporomandibular (Lovgren et al, 2017), risco para doença periodontal (Shimpi et al, 2019) e rastreio de infecções sexualmente transmissíveis (IST) (Karas et al, 2018).…”

Section: Tipos Aplicações E Finalidades De Sistemas De Apoio à Decisãounclassified

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Os labirintos da gestão, práticas, modelos de protocolo e financiamento em saúde

Jorge¹,

Moreira²,

Souza³

et al. 2022

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Os labirintos da gestão em saúde e suas práticas, modelos de protocolos e financiamento em saúde e suas interfaces convocam o leitor a adentrar um novo universo da gestão em saúde pós-pandemia que desestruturou os programas e estratégias montadas no combate das doenças endêmicas do Brasil, potencializando a disseminação de patologias psíquicas em proporções epidêmicas, além de vivência da reemergência de patologias erradicadas e/ou controladas. As entranhas do sistema de saúde têm nos apresentado rompimentos seculares em diversas áreas, em que vários fatores levam-nos a labirintos temerosos, como no caso da saúde mental, que vem sofrendo retrocessos importantes na forma de assistência, inclusive com incentivo ao retorno dos hospitais psiquiátricos. Os sistemas de informações do Ministério da Saúde (MS) vêm constantemente sofrendo hackeamentos, o que deixa todo gestor em constante receio de perder seus dados. Sabe-se que os sistemas de informação em saúde (SIS) sempre foram orgulho de nossos gestores, como também fonte de pesquisa e aparato para os repasses financeiros.

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Using a Clinical Decision Support Tool to Increase Chlamydia Screening Across a Large Primary Care Pediatric Network

Cited by 13 publications

References 8 publications

A Systematic Review of New Approaches to Sexually Transmitted Infection Screening Framed in the Capability, Opportunity, Motivation, and Behavior Model of Implementation Science

A Systematic Review of New Approaches to Sexually Transmitted Infection Screening Framed in the Capability, Opportunity, Motivation, and Behavior Model of Implementation Science

Improving Lead Screening Rates in a Large Pediatric Primary Care Network

Os labirintos da gestão, práticas, modelos de protocolo e financiamento em saúde

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