An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia

Electronic health record (EHR)-based clinical decision support (CDS) can address the low awareness and undertreatment of familial hypercholesterolemia (FH), a disorder associated with a markedly increased risk of coronary heart disease. We aimed to incorporate provider perspectives into the developm...

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Veröffentlicht in:Journal of personalized medicine 2020-09, Vol.10 (3), p.67
Hauptverfasser: Bangash, Hana, Pencille, Laurie, Gundelach, Justin H, Makkawy, Ahmed, Sutton, Joseph, Makkawy, Lenae, Dikilitas, Ozan, Kopecky, Stephen, Freimuth, Robert, Caraballo, Pedro J, Kullo, Iftikhar J
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container_issue 3
container_start_page 67
container_title Journal of personalized medicine
container_volume 10
creator Bangash, Hana
Pencille, Laurie
Gundelach, Justin H
Makkawy, Ahmed
Sutton, Joseph
Makkawy, Lenae
Dikilitas, Ozan
Kopecky, Stephen
Freimuth, Robert
Caraballo, Pedro J
Kullo, Iftikhar J
description Electronic health record (EHR)-based clinical decision support (CDS) can address the low awareness and undertreatment of familial hypercholesterolemia (FH), a disorder associated with a markedly increased risk of coronary heart disease. We aimed to incorporate provider perspectives into the development and implementation of a CDS tool for FH. An implementation science framework and a user-centered design process were used to create a CDS tool for FH. Primary care physicians and specialist physicians participated in qualitative interviews, usability testing and an implementation survey. The CDS was configured in two formats—a best practice alert (BPA) and an in-basket message and subsequently deployed in the EHR in silent mode. The key themes that emerged from the analysis of interview transcripts included understanding and awareness of FH, clinical workflow, physician preferences and value of CDS tools, perspectives on patient needs and values and dissemination and implementation. Recommendations related to usability included preferred CDS format and placement, content, timing and frequency, and level of alert urgency/prioritization. In response to the survey, 84.6% of physicians agreed that the CDS would improve early FH diagnosis and 92.3% agreed that it would help them identify and manage FH patients. Physician feedback led to iterative CDS refinement. In summary, we developed a CDS tool for FH using an implementation science framework and physician feedback. Initial deployment revealed a significant burden of FH and the potential for the CDS tool to have a large impact.
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subjects Cardiology
Cardiovascular disease
Care and treatment
Clinical medicine
Coronary artery disease
Decision support systems
Design
Electronic medical records
Electronic records
Etiology
Feedback
Heart diseases
Hypercholesterolemia
Internal medicine
Intervention
Interviews
Medical records
Medical research
Medicine
Methods
Patients
Physicians
Precision medicine
Primary care
Usability testing
title An Implementation Science Framework to Develop a Clinical Decision Support Tool for Familial Hypercholesterolemia
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