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10 Clinics within Stanford Health Care are randomized to receive or not receive provider alerts for 5 commonly overused tests and treatments.
10 Clinics within Stanford Health Care are randomized to receive or not receive provider alerts for 5 commonly overused tests and treatments.
Thus there will potentially be 50 clinics enrolled across the 5 tests/treatment categories. However, it is expected that some clinics will meet criteria to be one of the 10 clinics in more than test/treatment category. Thus the total number of clinics involved will be between 10 and 50.
These 5 tests / treatments are taken from the Choosing Wisely list. All alerts will be provided using the electronic medical record and will be automated.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Provider Alert | Active Comparator | This arm is the intervention arm. This arm will receive the Electronic Record Alert. |
|
| No Provider Alert | No Intervention | This arm is the control arm. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Electronic Record Alert | Behavioral | Electronic alert within the medical record indicating the ordered test or treatment may be inappropriate. The provider can indicate why the test or treatment is appropriate and complete the order. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of electronic orders entered per 100 clinic patients. | There are five primary outcomes for the five different alerts. For each alert study the outcome will be orders that would qualify for an alert per 100 patients. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Number of potential electronic alerts divided by the number of electronic orders | There will be five secondary outcomes which will be the alert candidate to order ratio. For both the control and intervention groups we will determine the fraction of orders that qualify for an alert. | 6 months |
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Inclusion Criteria:
High volume clinics defined as the top 10 clinics in Stanford Health Care based on number of electronic orders.
Exclusion Criteria:
None
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36018731 | Derived | Ho VT, Aikens RC, Tso G, Heidenreich PA, Sharp C, Asch SM, Chen JH, Shah NK. Interruptive Electronic Alerts for Choosing Wisely Recommendations: A Cluster Randomized Controlled Trial. J Am Med Inform Assoc. 2022 Oct 7;29(11):1941-1948. doi: 10.1093/jamia/ocac139. |
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