Research Project
7495064
Otitis media (OM)?infection of the middle ear--is the second most common disease in childhood, and by the[unreadable] time children enter school, 9 in 10 will have had at least one episode. It accounts for $5 billion in medical costs,[unreadable] and is the number one reason why physicians in the U.S. prescribe antibiotics. Physicians tend to overuse[unreadable] antibiotics for OM because it can be hard to diagnose, healthcare is often fragmented across multiple sites and[unreadable] clinicians, and some physicians are not aware of national guidelines that recommend more judicious use of these[unreadable] medicines. These quality problems will be addressed within the Children?s Hospital of Philadelphia (CHOP)[unreadable] primary care network, organized into a Pediatric Research Consortium, which has >180,000 children managed[unreadable] by 300+ pediatricians from 28 practices in 3 states. Our intervention will use CHOP?s electronic health record to[unreadable] integrate care across time and to supply physicians with the knowledge they need about how to treat a patient at[unreadable] the point of care. The full intervention comprises (1) a method for linking all services a patient received from[unreadable] any physician into clinically logical clusters called episodes-of-care, (2) clinical decision support for medications[unreadable] and referrals to specialists that are based on the best available scientific evidence, (3) feedback on past[unreadable] performance of OM care provided to physicians, and (4) physician training on how to use the tools. The study[unreadable] will randomly allocate 28 primary care practices into usual care, full intervention, and full intervention without[unreadable] feedback. We have included an arm to specifically test the independent contribution of feedback on quality,[unreadable] because the evidence in support of its effects is mixed. The project?s specific aims are:[unreadable] Aim 1 1: To develop and[unreadable] pilot test the OM health Information Technology (IT) intervention;[unreadable] Aim 2 2: To examine the overall effect of the[unreadable] health IT intervention and the independent contribution of physician feedback on quality (primary outcomes);[unreadable] and,[unreadable] Aim 3 3: To assess the effects of the intervention on the secondary outcomes of resource use and clinician[unreadable] adoption of the technology. Upon project completion, we will work with members of our advisory board,[unreadable] including the American Board of Pediatrics, NCQA, and Child Health Corporation of America, to disseminate[unreadable] our work nationally to child health professionals. Because OM is such a common disorder in children, the[unreadable] widespread adoption of the results from this project has the potential for affecting lives of millions of children.[unreadable] :
