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Population-oriented ICT-supported preventive care: Coping with local circumstances


- candidate number3075
- NTR NumberNTR1227
- ISRCTNISRCTN wordt niet meer aangevraagd
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR17-mrt-2008
- Secondary IDs6100.0011 ZONMW
- Public TitlePopulation-oriented ICT-supported preventive care: Coping with local circumstances
- Scientific TitlePopulation-oriented ICT-supported preventive care: Coping with local circumstances in primary health care
- ACRONYMSUNRISE
- hypothesisComputerized decision support (CDSS) for tailoring prevention to the local circumstances using the guidelines of the Dutch college of general practitioners has impact on preventive activities in the primary care setting
- Healt Condition(s) or Problem(s) studiedPrimary care, Prevention, Computerized decision support, Electronic health record, Information and Communication Technology (ICT)
- Inclusion criteria1. Primary care practices in the Netherlands that use the HetHIS (Microbias) EHR to record patient encounters
- Exclusion criteria1. Practices that have been working with the HetHIS EHR for less than a year preceding enrollment
2. Practices that use paper to record patient interactions
- mec approval receivedyes
- multicenter trialno
- randomisedyes
- masking/blindingSingle
- controlPlacebo
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-apr-2008
- planned closingdate31-mrt-2009
- Target number of participants50
- InterventionsSoftware module (SUNRISE) in the group randomized to recieve intervention that alerts users to the preventitive activities needed in their population based on the recommendations of the Dutch college of general practitioners. This module will be installed at the GP practices randomized to recieve the intervention for 360 days or until GP stops using the HEThis GP information system. The preventative activities can be tailored to the local practice profile and practice preference.
- Primary outcomeThe change in preventive activities performed by general practitioners in the participating practices during the study compared to the year preceding the study. That is the number of preventive activities that should be performed against the number of preventive activities that were performed as determined by the SUNRISE system. This is logged in the EHR during the study.
- Secondary outcomeThe change in DISEASE SPECIFIC preventive by general practitioners in the participating practices during the study compared to the year preceding the study. That is the number of preventive activities that should be performed against the number of preventive activities that were performed as determined by the SUNRISE system. This is logged in the EHR during the study.
- Timepoints- 2007 - contruction software
- up to 2008/03 - validation
- up to 2008/04 - recruitment
- 2008/04 - 2009/03 - trial
- 2009 Analysis
- Trial web siteN/A
- statusplanned
- CONTACT FOR PUBLIC QUERIESProf. Dr. Johan Lei, van der
- CONTACT for SCIENTIFIC QUERIESProf. Dr. Johan Lei, van der
- Sponsor/Initiator Erasmus Medical Center, Department of Medical Informatics
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development
- Publications1. Hunt DL, Haynes RB, Hanna SE, Smith K. Effects of computer-based decision support systems on physician performance and patient outcomes: A systematic review. Journal of the American Medical Association 1998;280(15):1339-1346.
2. Soumarai SB, McLaughlin TJ, Avorn J. Improving drug prescribing in primary care: A critical analysis of the experimental literature. The Millbank Quaterly 1989;67:268-317.
3. Grol RPTM. Successes and failures in the implementation of evidence-based guidelines for clinical practice. Medical Care 2001;39:1146-54.
4. Knottnerus JA. The role of electronic patient records in the development of generla practice in the Netherlands. Methods of Information in Medicine 1999;38:350-355.
5. Institute of Medicine. Crossing the quality chasm: A new health system for the 21st century. Washington DC: National Academy Press; 2001.
6. Bates D, Gawanda A. Improving safety with information technology. New England Journal of Medicine 2003;348:2526-2534.
7. Van Wijk MAM, Bohnen AM, Van der Lei J. Analysis of the practice guidelines of the Dutch College of General Practitioners with respect to the use of blood tests. Journal of the American Medical Informatics Association 1999;6:322-331.
8. Van Wijk MAM, Mosseveld BMT, Van der Lei J. The design of a decision-support system for test ordering in general practice: Choices and decisions to make. Methods of Information in Medicine 1999;38:355-361.
9. Van Wijk MAM, Van der Lei J, Mosseveld BMT, Bohnen AM, Van Bemmel JH. Assessment of decision support for blood test ordering in primary care: A randomized trial. Annals of Internal Medicine 2001;134:274-81.
10. Van Wijk MAM, Van der Lei J, Mosseveld BMT, Bohnen AM, van Bemel JH. Compliance of general practitioners with a guideline-based decision support system for ordering blood tests. Clinical Chemistry 2002;48(1):55-60.
11. Kuilboer MM, van Wijk MA, Mosseveld M, van der Does E, Ponsioen BP, de Jongste JC, et al. Feasibility of AsthmaCritic, a decision-support system for asthma and COPD which generates patient-specific feedback on routinely recorded data in general practice. Family Practice 2002;19(5):442-7.
12. Kuilboer MM, van Wijk MA, Mosseveld M, van der Lei J. AsthmaCritic: issues in designing a noninquisitive critiquing system for daily practice. Journal of the American Medical Informatics Association 2003;10(5):419-24.
13. Van Bemmel JH, Musen MA, editors. Handbook of Medical Informatics. Heidelberg, Germany: Springer Verlag; 1997.
14. Kuilboer MM. AsthmaCritic: a critiquing system and Asthma and COPD. PhD Thesis. Rotterdam: Erasmus University; 2003.
15. Vlug AE, Van der Lei J, Mosseveld BMT, Van Wijk MAM, Van der Linden PD, Sturkenboom MCJM, et al. Postmarketing surveillance based on electronic patient records: The IPCI project. Methods of Information in Medicine 1999;38:339-344.
16. Eland IA, Sturkenboom MC, van der Lei J, Wilson JH, Stricker BH. Incidence of acute pancreatitis. Scandinavian Journal of Gastroenterology 2002;37(1):124.
17. GW TJ, Eland IA, Sturkenboom MC, van den Anker JN, Stricker BH. Unlicensed and off label prescription of drugs to children: population based cohort study. British Medical Journal 2002;324(7349):1313-4.
18. Verboom P, Hakkaart-Van L, Sturkenboom M, De Zeeuw R, Menke H, Rutten F. The cost of atopic dermatitis in the Netherlands: an international comparison. British Journal of Dermatology 2002;147(4):716-24.
19. Verhamme KM, Dieleman JP, Bleumink GS, Bosch JL, Stricker BH, Sturkenboom MC. Treatment strategies, patterns of drug use and treatment discontinuation in men with LUTS suggestive of benign prostatic hyperplasia: the Triumph project. European Journal of Urology 2003;44(5):539-45.
20. Voordouw BC, van der Linden PD, Simonian S, van der Lei J, Sturkenboom MC, Stricker BH. Influenza vaccination in community-dwelling elderly: impact on mortality and influenza-associated morbidity. Archives of Internal Medicine 2003;163(9):1089-94.
21. Van der Lei J, Duisterhout JS, Westerhof HP, Van der Does E, Cromme PVM, Boon WM, et al. The introduction of computer-based patient records in the Netherlands. Annals of Internal Medicine 1993;119:1036-1041.
22. Van der Lei J, Musen MA, Van der Does E, Man in 't Veld AJ, Van Bemmel JH. Comparison of computer-aided and human review of general practitioners' management of hypertension. The Lancet 1991;338:1505-1508.
- Brief summaryPrevention is usually positioned as a separate, disease-specific activity (prevention of diabetes mellitus, prevention of cardiac diseases, etc.). In daily practice, workers in the health care system and often even the target groups themselves have to integrate (or select between) these separate preventive activities and merge them with other activities (e.g., curative care). Information and Communication Technology (ICT) is increasingly used to support preventive tasks. The intervention strategies developed for this purpose, however, are also characterized by a fragmented, disease oriented approach (one software module for cardiovascular screening, another module for diabetes, etc) -- even though the risk factors for individual diseases may overlap. Ideally, ICT aids an individual practitioner to deliver an effective, integrated set of preventive activities tailored to the special characteristics of the population served by that individual practitioner. As illustrated by the separate disease-specific modules, current intervention strategies that use ICT to support preventive tasks are based on the prevention in the setting of an individual disease; these interventions do not address the issue of providing, in an environment characterized by limited resources, the optimal set of preventive activities for an individual population over all diseases. In this study we will investigate the impact of an ICT-based intervention that allows the practitioner to tailor preventive activities to a local population and to local procedures. The intervention takes as starting point the generic activity prevention rather than prevention based on an individual disease. Rather than support preventive care in the context of an individual disease, we propose an intervention that supports selecting and tailoring prevention over multiple diseases to the characteristics of the local population in the light of the local circumstances. In this study we will conduct a randomized trial to study the feasibility of the intervention.
- Main changes (audit trail)
- RECORD18-feb-2008 - 17-mrt-2008


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