Provider Response to Computer-Based Care Suggestions for Chronic Heart Failure
Bibliographic Data
| ID | 9100234 |
|---|---|
| Authors | Brian Keeffe, Brian G Keeffe (VA Puget Sound Health Care System, corresponding author), Usha Subramanian (Regenstrief Institute), William M Tierney (0000-0002-3379-3014, Richard L. Roudebush VA Medical Center), Edmunds Udris, Edmunds M Udris (Health Services Research & Development, corresponding author), Jim Willems (University of Washington), Mary B McDonell (University of Washington, corresponding author), Mary McDonell, Stephan D Fihn (VA Puget Sound Health Care System, corresponding author) |
| Year | 2005 |
| Volume | 43 |
| Issue | 5 |
| Pages | 461-465 |
| Publication date | 2005-05-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000160378.53326.f3 |
| PMID | 15838410 |
| OpenAlex | W1968542643 |
| Language | EN |
| Citations received | 3 |
| References cited | 16 |
OBJECTIVES: We sought to assess the responses of providers to recommendations generated by a computer-management system for chronic heart failure (CHF). METHODS: This study is an analysis of primary care providers' responses to evidence-based computer-generated suggestions regarding patients with CHF at one center of a randomized trial. The trial randomized primary care providers from 2 VA Medical Centers to receive care suggestions regarding patients with CHF, with or without inclusion of patient symptom data obtained from pre-visit questionnaires. At one center, providers were asked to respond to the suggestions with hand-written comments and a numerical agreement scale. RESULTS: Providers responded to 774 care suggestions (62% of the 1246 delivered). They agreed with 41%, had major disagreements with 12%, and had minor disagreements with 22%. For 7% of the care suggestions, providers asked to not see it again for that patient. The most common reasons for major or minor disagreements were a belief that the suggestion was wrong or unnecessary (45%) or would not be tolerated by the patient (32%). External barriers to implementation of guidelines, lack of guideline awareness, or disagreement with guidelines were uncommon reasons cited by providers in this study. CONCLUSIONS: Providers agreed with less than half of computer-generated care suggestions from evidence-based CHF guidelines, most often because the suggestions were felt to be inapplicable to their patients or unlikely to be tolerated
Heart failure · Intensive care medicine · Medical emergency · MEDLINE · Political science · Diabetes Management and Education · Electronic Health Records Systems · Heart Failure Treatment and Management · Internal Medicine · Medicine
| Citations per year | 0.43 |
|---|---|
| Citation span | 2019 - 2023 (5) |
| Highly cited | No |