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Are asynchronous or synchronous clinical decision support more likely to change provider behavior? A case study in
Eric Matthew Puster1,2, Randall W Grout1, Paul R Dexter2
1Pediatrics, Eskenazi Health, Indianapolis, IN 46202, United States.
Objective:
Describe the impact of synchronous vs asynchronous clinical decision support (CDS) on clinician behavior in a single-site randomized, controlled environment.
Materials And Methods:
Mixed effects binomial logistic regression was used to compare the impact of synchronous against asynchronous messaging on neurology orders in a three-arm study.
Results:
Asynchronous messaging resulted in a significant increase in patient neurology orders for evaluation (Odds ratio, alert-only arm: 1.88; 95% CI: 1.39, 2.55; alert and questionnaire arm: 1.99; 95% CI: 1.52, 2.62).
Discussion:
Alerts sometimes generate little action on the part of clinicians. In this case, asynchronous inbox messaging significantly increased neurology orders.
Conclusion:
Depending on context, asynchronous messaging may be superior to synchronous messaging when recommending a referral in an outpatient setting.
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