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Electronic Health Record Clinical Decision Support Tool Improves Ambulatory Reflux Testing Practices
Alexander T Reddy1, Annie L Wang2, Sitharthan Sekar3
1Division of Gastroenterology, Duke University, Durham, North Carolina, USA.
Introduction:
Performing reflux testing on acid suppression without a confirmed diagnosis of gastroesophageal reflux disease conflicts with best practice recommendations and reduces diagnostic utility. We assessed whether clinical decision support (CDS) improves ordering practices.
Methods:
Quality improvement methods were used to develop and test the effectiveness of a novel CDS tool.
Results:
The testing rate on acid suppression decreased (30.9% vs 8.4%; P < 0.01), best practice concordance increased (16.4% vs 60.0%; P < 0.001), and more clinical management changes occurred (23.1% vs 60.0%; P = 0.01) after CDS deployment.
Discussion:
Use of CDS for reflux testing improves ordering practices and meaningful changes clinical management.
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