308775
Implementation of the PECARN traumatic brain injury prediction rules using electronic health record-based clinical decision support: An interrupted time series trial
Methods: Multicenter interrupted time-series trial with controls. We developed centrally and implemented across sites: a) a chief complaint-based process to trigger data collection for appropriate patients in the EHR; b) an EHR BHT data collection template that captures patient-specific risk factors necessary to assess the risk of clinically-important TBIs; c) CDS provided by either a platform-independent CDS cloud service or locally-provided CDS (i.e. using the local EHR’s CDS rules engine); and d) a data transfer process to extract data from the EHR and upload it to the PECARN data center. The CDS provides clinicians patient-specific CDS in real-time, with recommendations regarding CT use. We will measure change in CT use and patient outcomes before and after CDS within and across sites.
Results: We have successfully implemented all aspects of the trial, including implementation of the CDS cloud-service at two sites. Data collection is ongoing, with more than 25,000 patients having data successfully transferred to the data center.
Conclusions/Implications: BHT data collection in the EHR, resulting in the provision of patient-specific CDS, can be implemented across sites using a centralized development process with local implementation.
Learning Areas:
Clinical medicine applied in public healthCommunication and informatics
Provision of health care to the public
Learning Objectives:
Describe how the electronic health record can be used to aid in decision support for children with minor blunt head trauma in the emergency department.
Define knowledge translation and its relationship to research.
Keyword(s): Decision-Making, Traumatic Brain Injury
Qualified on the content I am responsible for because: I have been a statistician with the PECARN network for eight years. I have been chair of the data committee for five years and a member of the section for 15 years.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.