Disseminating child abuse clinical decision support among commercial electronic health records: Effects on clinical practice

• DOI: 10.1093/jamiaopen/ooad022
• Publication Date: 2023-04-13T19:30:54Z
• Authors: David A Feldstein; Isabel Barata; Thomas McGinn; Emily Heineman; Joshua Ross; Dana Kaplan; Francesca Bullaro; Sundas Khan; Nicholas Kuehnel; Rachel P Berger
• Keywords: Health records; Electronic health record

The use of electronic health record (EHR)-embedded child abuse clinical decision support (CA-CDS) may help decrease morbidity from maltreatment. We previously reported on the development CA-CDS in Epic and Allscripts. objective this study was to implement into Allscripts determine its effects identification, evaluation, reporting suspected maltreatment.After a preimplementation period, implemented at University Wisconsin (Epic) Northwell Health (Allscripts). Providers were surveyed before go-live 4 months later. Outcomes included proportion children who triggered system, had positive Child Abuse Screen (CAS) and/or Protective Services (CPS).At (UW), 3.5% implementation period system. CAS 1.8% children. CPS increased 0.6% 0.9%. There rapid uptake order set.At (NW), 1.9% 1% set rarely used. Preimplementation, providers both sites similar desire have system perception CDS general. After implementation, UW while NW negative perception.CA-CDS able be 2 different EHRs with differing care provider feedback. At UW, site higher rate previous studies there an increase cases identified as measured by reports CPS. Our data demonstrate how local environment, end-users' opinions, limitations EHR platform can impact success implementation.When disseminating hospital systems EHRs, it is critical recognize functionality implementation. importance collecting, interpreting, responding feedback particularly related