Gill James, Kucharski Kathrin, Turk Barbara, Pan Chunshen, Wei Wenhui
Delaware Valley Outcomes Research, Newark, Delaware (Dr Gill and Ms Turk); independent consultant (Dr Kucharski); Sanofi US, Inc, Bridgewater, New Jersey (Dr Pan); and Regeneron Pharmaceuticals Inc, Tarrytown, New York (Dr Wei).
J Ambul Care Manage. 2019 Apr/Jun;42(2):105-115. doi: 10.1097/JAC.0000000000000267.
This prospective, randomized, real-world study aimed to examine the impact of electronic health record-based clinical decision support (CDS) tools on the management of diabetes in small- to medium-sized primary care practices participating in Delaware's patient-centered medical home project. Overall, use of CDS systems was associated with greater reductions from baseline in hemoglobin A1c and low-density lipoprotein cholesterol, and more patients achieving treatment goals. Physicians and staff reported that the CDS toolkit empowered them to be more involved in clinical decision-making, thereby helping to improve diabetes care. However, all cited significant barriers to fully implementing team-based CDS, predominantly involving time and reimbursement.
这项前瞻性、随机、真实世界研究旨在考察基于电子健康记录的临床决策支持（CDS）工具对参与特拉华州以患者为中心的医疗之家项目的中小型基层医疗实践中糖尿病管理的影响。总体而言，CDS系统的使用与糖化血红蛋白和低密度脂蛋白胆固醇较基线水平有更大幅度的降低相关，且更多患者实现了治疗目标。医生和工作人员报告称，CDS工具包使他们能够更多地参与临床决策，从而有助于改善糖尿病护理。然而，所有人都提到了全面实施基于团队的CDS的重大障碍，主要涉及时间和报销问题。
