D S Cannon1, S N Allen. 1. University of Utah, Salt Lake City, USA. dale.cannon@med.va.gov
Abstract
OBJECTIVE: To evaluate the relative effectiveness of computer and manual reminder systems on the implementation of a clinical practice guideline. DESIGN:Seventy-eight outpatients in a mental health clinic were randomly assigned within clinician to one of the two reminder systems. The computer system, called CaseWalker, reminded clinicians when guideline-recommended screening for mood disorder was due, ensured the fidelity of the diagnosis of major depressive disorder to criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), and generated a progress note. The manual system was a checklist inserted in the paper medical record. MEASURES: Screening rates for mood disorder and the completeness of the documentation of which DSM-IV criteria were met by patients who were said to have major depressive disorder were compared. RESULTS: The CaseWalker, compared with the paper checklist, resulted in a higher screening rate for mood disorder (86.5 vs. 61 percent, P = 0.008) and a higher rate of complete documentation of DSM-IV criteria (100 vs. 5.6 percent, P < 0.001). CONCLUSIONS: In an outpatient mental health clinic, computer reminders were shown to be superior to manual reminders in improving adherence to a clinical practice guideline for depression.
RCT Entities:
OBJECTIVE: To evaluate the relative effectiveness of computer and manual reminder systems on the implementation of a clinical practice guideline. DESIGN: Seventy-eight outpatients in a mental health clinic were randomly assigned within clinician to one of the two reminder systems. The computer system, called CaseWalker, reminded clinicians when guideline-recommended screening for mood disorder was due, ensured the fidelity of the diagnosis of major depressive disorder to criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), and generated a progress note. The manual system was a checklist inserted in the paper medical record. MEASURES: Screening rates for mood disorder and the completeness of the documentation of which DSM-IV criteria were met by patients who were said to have major depressive disorder were compared. RESULTS: The CaseWalker, compared with the paper checklist, resulted in a higher screening rate for mood disorder (86.5 vs. 61 percent, P = 0.008) and a higher rate of complete documentation of DSM-IV criteria (100 vs. 5.6 percent, P < 0.001). CONCLUSIONS: In an outpatient mental health clinic, computer reminders were shown to be superior to manual reminders in improving adherence to a clinical practice guideline for depression.
Authors: Richard R Owen; Carol R Thrush; Dale Cannon; Kevin L Sloan; Geoff Curran; Teresa Hudson; Mark Austen; Mona Ritchie Journal: J Am Med Inform Assoc Date: 2004-06-07 Impact factor: 4.497
Authors: Linda S Williams; Susan Ofner; Zhangsheng Yu; Rebecca J Beyth; Laurie Plue; Teresa Damush Journal: J Gen Intern Med Date: 2011-08 Impact factor: 5.128
Authors: Constance H Fung; Jerry S Tsai; Armine Lulejian; Peter Glassman; Emily Patterson; Brad N Doebbeling; Steven M Asch Journal: J Gen Intern Med Date: 2008-04 Impact factor: 5.128
Authors: Gianfranco Damiani; Luigi Pinnarelli; Simona C Colosimo; Roberta Almiento; Lorella Sicuro; Rocco Galasso; Lorenzo Sommella; Walter Ricciardi Journal: BMC Health Serv Res Date: 2010-01-04 Impact factor: 2.655