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The effectiveness of computerized clinical guidelines in the process of care: a systematic review.

Damiani G, Pinnarelli L, Colosimo SC, Almiento R, Sicuro L, Galasso R, Sommella L, Ricciardi W - BMC Health Serv Res (2010)

Bottom Line: The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown.Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health-Università Cattolica Sacro Cuore-Rome, Rome, Italy. gdamiani@rm.unicatt.it

ABSTRACT

Background: Clinical practice guidelines have been developed aiming to improve the quality of care. The implementation of the computerized clinical guidelines (CCG) has been supported by the development of computerized clinical decision support systems.This systematic review assesses the impact of CCG on the process of care compared with non-computerized clinical guidelines.

Methods: Specific features of CCG were studied through an extensive search of scientific literature, querying electronic databases: Pubmed/Medline, Embase and Cochrane Controlled Trials Register. A multivariable logistic regression was carried out to evaluate the association of CCG's features with positive effect on the process of care.

Results: Forty-five articles were selected. The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.

Conclusions: From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.

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Related in: MedlinePlus

Selection process of studies on computerized guidelines.
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Figure 1: Selection process of studies on computerized guidelines.

Mentions: A total number of 2,996 articles out of 3,502 was excluded because of the title and the content of abstract. Then, 191 out of 506 studies met the inclusion criteria. Forty-five articles were included in the final selection [14,15,22-64]. (Figure 1). Some of the articles included in Garg's and Kawamoto reviews [6,12] were excluded by our selection [see Additional file 1]. The characteristics of selected studies are shown in Table 3.


The effectiveness of computerized clinical guidelines in the process of care: a systematic review.

Damiani G, Pinnarelli L, Colosimo SC, Almiento R, Sicuro L, Galasso R, Sommella L, Ricciardi W - BMC Health Serv Res (2010)

Selection process of studies on computerized guidelines.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2837004&req=5

Figure 1: Selection process of studies on computerized guidelines.
Mentions: A total number of 2,996 articles out of 3,502 was excluded because of the title and the content of abstract. Then, 191 out of 506 studies met the inclusion criteria. Forty-five articles were included in the final selection [14,15,22-64]. (Figure 1). Some of the articles included in Garg's and Kawamoto reviews [6,12] were excluded by our selection [see Additional file 1]. The characteristics of selected studies are shown in Table 3.

Bottom Line: The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown.Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health-Università Cattolica Sacro Cuore-Rome, Rome, Italy. gdamiani@rm.unicatt.it

ABSTRACT

Background: Clinical practice guidelines have been developed aiming to improve the quality of care. The implementation of the computerized clinical guidelines (CCG) has been supported by the development of computerized clinical decision support systems.This systematic review assesses the impact of CCG on the process of care compared with non-computerized clinical guidelines.

Methods: Specific features of CCG were studied through an extensive search of scientific literature, querying electronic databases: Pubmed/Medline, Embase and Cochrane Controlled Trials Register. A multivariable logistic regression was carried out to evaluate the association of CCG's features with positive effect on the process of care.

Results: Forty-five articles were selected. The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.

Conclusions: From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.

Show MeSH
Related in: MedlinePlus