Case study
TeenBP: Development and Piloting of an EHR-linked Clinical Decision Support System to Improve Recognition of Hypertension in Adolescents
Authors:
Elyse O. Kharbanda ,
HealthPartners Institute for Education and Research
About Elyse O.
MD, MPH
James D. Nordin,
HealthPartners Institute for Education and Research
About James D.
MD, MPH
Alan R. Sinaiko,
University of Minnesota, Department of Pediatrics
About Alan R.
MD
Heidi L. Ekstrom,
HealthPartners Institute for Education and Research
About Heidi L.
MA
Jerry M. Stultz,
HealthPartners Medical Group
About Jerry M.
MD
Nancy E. Sherwood,
HealthPartners Institute for Education and Research
About Nancy E.
PhD
Patricia L. Fontaine,
HealthPartners Institute for Education and Research
About Patricia L.
MD
Steve E. Asche,
HealthPartners Institute for Education and Research
About Steve E.
MA
Steven P. Dehmer,
HealthPartners Institute for Education and Research
About Steven P.
PhD
Jerry H. Amundson,
HealthPartners Institute for Education and Research
About Jerry H.
BS
Deepika X. Appana,
HealthPartners Institute for Education and Research
About Deepika X.
BS
Anna R. Bergdall,
HealthPartners Institute for Education and Research
About Anna R.
MPH
Marcia G. Hayes,
HealthPartners Institute for Education and Research
About Marcia G.
MPH
Patrick J. O'Connor
HealthPartners Institute for Education and Research
About Patrick J.
MD, MPH, MA
Abstract
Context: Blood pressure (BP) is routinely measured in children and adolescents during primary care visits. However, elevated BP or hypertension is frequently not diagnosed or evaluated further by primary care providers. Barriers to recognition include lack of clinician buy-in, competing priorities, and complexity of the standard BP tables.
Case Description: We have developed and piloted TeenBP— a web-based, electronic health record (EHR) linked system designed to improve recognition of prehypertension and hypertension in adolescents during primary care visits.
Major Themes: Important steps in developing TeenBP included the following: review of national BP guidelines, consideration of clinic workflow, engagement of clinical leaders, and evaluation of the impact on clinical sites. Use of a web-based platform has facilitated updates to the TeenBP algorithm and to the message content. In addition, the web-based platform has allowed for development of a sophisticated display of patient-specific information at the point of care. In the TeenBP pilot, conducted at a single pediatric and family practice site with six clinicians, over a five-month period, more than half of BPs in the hypertensive range were clinically recognized. Furthermore, in this small pilot the TeenBP clinical decision support (CDS) was accepted by providers and clinical staff. Effectiveness of the TeenBP CDS will be determined in a two-year cluster-randomized clinical trial, currently underway at 20 primary care sites.
Conclusion: Use of technology to extract and display clinically relevant data stored within the EHR may be a useful tool for improving recognition of adolescent hypertension during busy primary care visits. In the future, the methods developed specifically for TeenBP are likely to be translatable to a wide range of acute and chronic issues affecting children and adolescents.
How to Cite:
Kharbanda EO, Nordin JD, Sinaiko AR, Ekstrom HL, Stultz JM, Sherwood NE, et al.. TeenBP: Development and Piloting of an EHR-linked Clinical Decision Support System to Improve Recognition of Hypertension in Adolescents. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2015;3(2):9. DOI: http://doi.org/10.13063/2327-9214.1142
Published on
09 Jul 2015.
Peer Reviewed
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