Computer system helps physicians identify risk factors

An automated system helps pediatricians screen children for risk factors and focus on the specific needs of the patient, researchers from the Regenstrief Institute report.

A study conducted in a large, urban, public health care system showed that a computerized clinical decision support system yielded positive screening rates for identifiable risk factors.

The Child Health Improvement through Computer Automation (CHICA) system uses information acquired from the patient, parent, or other family member while in the waiting room, coupled with preexisting data from an electronic medical record (EMR) system to generate patient-specific recommendations and reminders for the physician.

Using paper and pencil, family members answer 20 yes or no questions tailored to the patient’s age and medical history. A nurse scans the responses into the EMR before the pediatrician sees the child, and the system generates a physician worksheet containing alerts and reminders regarding routine care, follow-up, and patient risk factors.

In a cohort of nearly 17,000 patients, 408,000 questions were asked in 32,000 visits; 89% of the questions yielded a response. Of those, almost 40,000 (11%) identified positive risk screens in younger children and adolescents that needed to be addressed in well-child visits.

The researchers conclude that by automating the process of screening patients in the waiting room with a tailored questionnaire and alerting the physician to those who screen positive for identifiable risks, providers can significantly decrease the burden of identifying and prioritizing relevant guidelines and screenings in their practice.

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