Studying physician use and satisfaction with web-based treatment guides that incorporate patient information from the electronic medical record [abstract]

Abstract

Clinical decision support tools are important components of the electronic medical record. Previous studies have demonstrated that such tools can directly improve patient care outcomes and the performance of healthcare organizations. Decision support tools can be used within reference materials, order sets, electronic alerts, as well as clinical guidelines. The development and use of clinical decision support tools at the point-of-care offers clinicians the ability to analyze patient data in real-time while making critical decisions. One method of providing such a clinical decision support tool is integrating tools into the World Wide Web. We integrated a freely available online hyperbilirubinemia risk assessment tool, known as "BiliTool," with our electronic medical record. Integration consisted of embedded a hyperlink to "BiliTool" in a neonatal-specific data summary screen. By clicking the hyperlink, the "BiliTool" website is launched and de-identified total bilirubin levels and hours of life are input by the computer through standard HTTP protocols. Assessment results for these variables are displayed in the web browser. The end-result of clicking the hyperlink is an automated bilirubin risk assessment and suggested course of treatment. We surveyed Child Health and Family and Community Medicine residents who have been on duty in the Well Baby Nursery since the launch of the "BiliTool" integration into the electronic medical record for their use and satisfaction with the automated web-based treatment guideline.