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Using computerized clinical decision support for latent tuberculosis infection screening.

Andy W Steele¹, Sheri Eisert, Art Davidson

¹Information Services, Denver Health (1932), 660 Bannock Street, Denver, CO 80218, USA. asteele@dhha.org

American Journal of Preventive Medicine

|March 16, 2005

Summary

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Computerized clinical decision support significantly increased latent tuberculosis infection (LTBI) screening rates by 183% in high-risk patients. This technology shows promise for improving preventive care for various conditions.

Area of Science:

Public Health
Infectious Disease Management
Health Informatics

Background:

Centers for Disease Control and Prevention (CDC) guidelines recommend screening for latent tuberculosis infection (LTBI) in high-risk populations.
The study aimed to evaluate the effectiveness of technological interventions in improving LTBI screening rates.

Purpose of the Study:

To assess the impact of computerized clinical decision support and guided web-based documentation on LTBI screening adherence.
To determine if these tools improve the identification of high-risk individuals for LTBI screening.

Main Methods:

A nonrandomized, prospective intervention study involving 8463 patients in community health centers.
Implementation of a computerized system with alerts for LTBI risk criteria (high-risk country birth, age <40) and a web-based documentation tool.

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Data collection occurred over baseline (15 weeks) and study (12 weeks) phases, with chart reviews for outcome assessment.

Main Results:

Among 4135 patients in the post-intervention phase, 73% had risk factors, and 610 met alert criteria for LTBI screening.
Adherence to LTBI screening guidelines significantly increased from 8.9% at baseline to 25.2% during the study phase (183% increase, p < 0.001).

Conclusions:

Computerized clinical decision support and guided documentation effectively increased LTBI screening in high-risk patients.
This technological approach has the potential to enhance LTBI screening nationwide and improve care for other preventive and chronic diseases.