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Updated: Jun 28, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Using computerized provider order entry and clinical decision support to improve referring physicians' implementation
Martin C Were1, Greg Abernathy, Siu L Hui
1Indiana University School of Medicine, Indianapolis, Indiana 46202-3012, USA. mwere@regenstrief.org
Objectives:
Only half of consultants' medical recommendations are implemented. We created a tool that lets referring providers review and implement electronic recommendations made by consultants, with the hypothesis that facilitation with our tool could improve implementation.
Measurements:
The tool was piloted among geriatrics consultants and hospitalists. Pre-post evaluation was done with control (before pilot; N=20) and intervention (after pilot; N=20) patients. Consultants wrote notes containing recommendations for all study patients, and entered electronic recommendations only for intervention patients. We analyzed all recommendations and surveyed hospitalists.
Results:
A total of 249 recommendations were made for intervention patients versus 192 for controls (p<0.05). Of all recommendations about intervention patients, 78% were implemented, compared to 59% for controls (p=0.01). Of the intervention recommendations, 77% were entered electronically using our tool; of these, 86% were implemented. All 24 survey respondents indicated that the system improved quality, saved time, and should be expanded.
Conclusion:
Consultant recommendations were implemented 30% more often when there was electronic facilitation of recommendations.
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