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Use of a clinical decision support system to increase osteoporosis screening
Article first published online: 15 AUG 2010
© 2010 Blackwell Publishing Ltd
Journal of Evaluation in Clinical Practice
Volume 18, Issue 1, pages 89–92, February 2012
How to Cite
DeJesus, R. S., Angstman, K. B., Kesman, R., Stroebel, R. J., Bernard, M. E., Scheitel, S. M., Hunt, V. L., Rahman, A. S. and Chaudhry, R. (2012), Use of a clinical decision support system to increase osteoporosis screening. Journal of Evaluation in Clinical Practice, 18: 89–92. doi: 10.1111/j.1365-2753.2010.01528.x
- Issue published online: 5 JAN 2012
- Article first published online: 15 AUG 2010
- Accepted for publication: 28 June 2010
- clinical decision support system;
- delivery of health care;
- mass screening;
Background In 2002, the US Preventive Services Task Force recommended routine osteoporosis screening for women aged 65 years or older. However, studies have indicated that osteoporosis remains underdiagnosed, and various methods such as the use of health information technology have been tried to increase screening rates. We investigated whether we could boost the low rates of bone mineral density testing with implementation of a point-of-care clinical decision support system in our primary care practice.
Methods We retrospectively reviewed the medical records of female patients eligible for osteoporosis screening who had no prior bone mineral density test who were seen at our primary care practice sites in 2007 or 2008 (before and after implementation of a point-of-care clinical decision support system).
Results Overall, screening rates were 80.1% in 2007 and 84.1% in 2008 (P < 0.001). Of patients who did not have osteoporosis screening before the visit, 5.87% completed the screening after the visit in 2007, compared with 9.79% in 2008 (when the clinical support system was implemented), a 66.7% improvement (P = 0.025).
Conclusion Clinical decision support for primary care doctors significantly improved osteoporosis screening rates among eligible women. Carefully designed clinical decision support systems can optimize care delivery, ensuring that important preventive services such as osteoporosis screening for patients at risk for fracture are performed while unnecessary testing is avoided.