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Nudging Provider Adoption of Clinical Decision Support

推动提供商采用临床决策支持

基本信息

批准号：
10610964
负责人：
Safiya Richardson
金额：
$ 17.1万
依托单位：
NEW YORK UNIVERSITY SCHOOL OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-12-15 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10610964
关键词：
Address Adoption Angiography Antibiotics Applications Grants Award Behavior Behavioral Behavioral Sciences Caring Cessation of life Clinical Trials Design Competence Complement Consent Data Decision Making Development Development Plans Disparity Effectiveness Embolism Enrollment Feedback Funding Goals Health Health Personnel Healthcare Hospitals Internal Medicine Interview Kidney Diseases Lead Lung Malignant Neoplasms Medical Mentors Methods Modeling Morbidity - disease rate Motivation New York Organ Donations Outcome Physicians Policy Maker Positioning Attribute Positive Reinforcements Probability Process Provider Public Health Informatics Pulmonary Embolism Quality of Care Recommendation Research Research Activity Research Personnel Research Project Grants Scanning Scientist Specific qualifier value Structure Suggestion Surveys Testing Training Training Activity United States United States National Institutes of Health X-Ray Computed Tomography behavior change behavioral economics career career development clinical decision support clinical practice computerized design effectiveness evaluation efficacy outcomes evidence base experience health information technology improved mortality pilot trial prevent process evaluation prototype provider adoption provider behavior psychologic risk prediction satisfaction secondary outcome social support tools theories tool usability wasting

项目摘要

ABSTRACT With the long term career goal of becoming a leading independent researcher transforming health information technology, Safiya I. Richardson, MD, MPH, proposes a mentored research project and specific career development plan which will prepare her to use behavioral science to develop effective clinical decision support (CDS). The disparity between usual and evidenced based clinical practice is responsible for a third of hospital deaths and waste estimated at 380 billon dollars each year. Computerized CDS has the potential to narrow this gap by bringing meaningful and relevant evidence to health care providers at the point of decision making. However, moderate improvements in care seen with CDS are significantly limited by consistently low provider adoption, estimated at 10%. This project uses behavioral theory and key principles of behavioral economics to illuminate and address barriers to provider adoption of CDS. Using the Capability Opportunity Motivation Behavior (COM-B) framework Dr. Richardson will examine barriers to provider adoption of a pulmonary embolism risk prediction CDS tool. The use of CDS to assess pre- test probability before computed tomography pulmonary angiography reduces testing by 25% without any missed pulmonary emboli. Routine use by providers would result in 600,000 fewer scans, 84,000 fewer cases of contrast induced nephropathy and prevent 3,000 malignancies as well as 2,000 cancer deaths in the United States every year. The overall objective of this training application is to develop and evaluate the feasibility and preliminary efficacy on provider adoption of a new tool that incorporates nudges designed to address barriers to tool use. Nudges are applications of behavioral science used by behavioral economists, defined as positive reinforcement and indirect suggestions which have a non-forced effect on decision making. The proposal aims to: 1) develop nudges designed to address identified behavioral barriers to adoption, 2) build and conduct iterative usability testing on prototypes of the new tool, 3) evaluate the feasibility and preliminary efficacy on provider adoption of the new tool compared to the current tool, in a pilot trial. This project uses a multistage mixed methods framework. It is the first to evaluate the impact of nudges on provider adoption of CDS. This research is complemented by career development activities, including formal training in health informatics, behavioral science, mixed methods and clinical trial design. With the guidance of an experienced mentoring team, the proposed research and training activities will lead to the development a competitive R01 grant application to assess the effectiveness of the new tool to improve health outcomes.

摘要

项目成果

期刊论文数量（23）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

In-Hospital 30-Day Survival Among Young Adults With Coronavirus Disease 2019: A Cohort Study.

DOI：
10.1093/ofid/ofab233
发表时间：
2021-06
期刊：
Open forum infectious diseases
影响因子：
4.2
作者：
Richardson S;Gitlin J;Kozel Z;Levy S;Rahman H;Hirsch JS;McGinn T;Diefenbach MA
通讯作者：
Diefenbach MA

A framework for digital health equity.