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Using state administrative and pharmacy data bases to develop a clinical decision support tool for schizophrenia
Molly Finnerty1, Richard Altmansberger, James Bopp
1Bureau of Evidence based Medicine and Clinical Guidelines, New York State Office of Mental Health, Albany 12229, USA. comdmtf@omh.state.ny.us
Schizophrenia Bulletin
|June 6, 2002
Summary
Administrative and pharmacy databases can be leveraged for clinical decision support. This study shows their feasibility for developing schizophrenia guideline adherence reports, achieving high physician acceptance.
Area of Science:
- Health Informatics
- Clinical Quality Improvement
- Mental Health Services Research
Background:
- Administrative and pharmacy databases offer untapped potential for clinical decision support.
- Implementing evidence-based guidelines, such as those for schizophrenia, is crucial for quality care.
- Existing data infrastructure limitations can hinder the development of effective clinical support tools.
Purpose of the Study:
- To assess the feasibility of utilizing New York State Office of Mental Health (NYSOMH) databases for automated clinical reporting.
- To support the implementation of schizophrenia treatment guidelines through data-driven insights.
- To evaluate physician acceptability of guideline-based decision support tools derived from administrative data.
Main Methods:
- Reviewed NYSOMH administrative and pharmacy database structures for suitability and limitations.
- Identified key schizophrenia guideline recommendations and adherence metrics for focus.
- Programmed a preliminary clinical report based on operational definitions of guideline recommendations.
- Engaged user groups in an iterative process of field testing, feedback, and revision to refine report content and format.
Main Results:
- Administrative and pharmacy databases, despite inherent limitations, can be adapted for clinical decision support.
- An automated clinical report supporting schizophrenia guideline implementation was successfully developed.
- The developed decision support tool demonstrated high acceptability among physicians.
- Iterative feedback from user groups was essential for refining the report's utility and format.
Conclusions:
- Administrative and pharmacy data are valuable resources for developing clinical decision support tools in mental health.
- Automated reporting based on these databases can effectively support the implementation of schizophrenia guidelines.
- Physician acceptance is achievable for data-driven clinical decision support tools when developed collaboratively.