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Related Experiment Video

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Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
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Using Clinical Decision Support Within the Electronic Health Record to Reduce Incorrect Prescribing for Acute

Regina Ginzburg1,2, Justin J Conway3, Eve Waltermaurer2

  • 1St. John's University, Queens, NY.

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|August 16, 2019
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Summary
This summary is machine-generated.

Electronic best practice alerts (BPAs) significantly reduced antibiotic prescribing for acute sinusitis by 31%. These clinical reminders in the electronic health record (EHR) improved provider decisions and decreased incorrect antibiotic use.

Keywords:
antibiotic prescribingbest practice alertdecision supportelectronic health recordssinusitis

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Area of Science:

  • Infectious Diseases
  • Health Informatics
  • Clinical Decision Support

Background:

  • Acute sinusitis is predominantly viral (>90%), yet antibiotics are overprescribed (>80%) in the US.
  • Computer-assisted guidelines reduce inappropriate antibiotic prescribing for respiratory infections.
  • Limited research exists on electronic best practice alerts (BPAs) for acute sinusitis treatment.

Purpose of the Study:

  • To evaluate the impact of electronic best practice alerts (BPAs) on antibiotic prescribing for acute sinusitis.
  • To assess the effectiveness of EHR-integrated advisories in improving treatment decisions.

Main Methods:

  • Observational cohort study at a Federally Qualified Health Center.
  • Compared prescribing behavior one year before and during the first year of BPA implementation.
  • BPAs provided reminders and links to national guidelines within the EHR.

Main Results:

  • Antibiotic prescribing for sinusitis decreased by 31% (RR: 0.69).
  • Incorrect prescribing rates reduced from 88.5% to 78.7% (P=0.02).
  • Adjustments were made for patient and provider factors.

Conclusions:

  • EHR-based clinical reminders (BPAs) effectively reduce inappropriate antibiotic use for acute sinusitis.
  • BPAs improve provider decision-making regarding appropriate antibiotic selection.
  • This technology supports evidence-based practice in managing acute sinusitis.