• Open Access

Use of a Web-based clinical decision support system to improve abdominal aortic aneurysm screening in a primary care practice

Authors


  • Competing interests : Dr Chaudhry is an employee of Mayo Clinic and the inventor of GDMS referenced in this publication. Mayo Clinic has licensed this technology to a commercial entity (VitalHealth Software) but to date has received no royalties. Dr Chaudhry receives no royalties from the licensing of this technology.

  • Author contributions: All Authors participated in the data analysis and helped draft the manuscript. R. C. conceived the study.

  • Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms

Dr Rajeev Chaudhry, Division of Primary Care Internal Medicine, Center for Innovation, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA, E-mail: rajeev@mayo.edu

Abstract

Rationale, aims and objectives  The United States Preventive Services Task Force recommends a one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography for men aged 65 to 75 years who have ever smoked. However, despite a mortality rate of up to 80% for ruptured AAAs, providers order the screening for a minority of patients. We sought to determine the effect of a Web-based point-of-care clinical decision support system on AAA screening rates in a primary care practice.

Methods  We conducted a retrospective review of medical records of male patients aged 65 to 75 years who were seen at any of our practice sites in 2007 and 2008, before and after implementation of the clinical decision support system.

Results  Overall screening rates were 31.36% in 2007 and 44.09% in 2008 (P-value: <0.001). Of patients who had not had AAA screening prior to the visit, 3.22% completed the screening after the visit in 2007, compared with 18.24% in 2008 when the clinical support system was implemented, 5.36 times improvement (P-value: <0.001).

Conclusions  A Web-based clinical decision support for primary care physicians significantly improved delivery of AAA screening of eligible patients. Carefully developed clinical decision support systems can optimize care delivery, ensuring that important preventive services are delivered to eligible patients.

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