Using state administrative and pharmacy data bases to develop a clinical decision support tool for schizophrenia guidelines.
Administrative and pharmacy data bases represent a largely untapped resource for clinical decision support and quality improvement. In this study, we examined the feasibility of using New York State Office of Mental Health (NYSOMH) data bases to develop an automated clinical report to support implementation of schizophrenia guidelines. First we reviewed the structure of existing data bases for capacity and limitations in supporting guideline implementation. Second, we identified schizophrenia guideline recommendations and adherence measures that would be the focus of our implementation. Third, a preliminary report was programmed, based on operational definitions of the guideline recommendations. Finally, we developed user groups to define content and format of new reports, through an iterative process of field testing, feedback, and revision. Our experience suggests that administrative and pharmacy data bases, despite their limitations, can be used to develop guideline-based clinical decision support tools for schizophrenia with high physician acceptability.
Finnerty
Molly
M
Bureau of Evidence based Medicine and Clinical Guidelines, New York State Office of Mental Health, Albany 12229, USA. comdmtf@omh.state.ny.us
Altmansberger
Richard
R
Bopp
James
J
Carpinello
Sharon
S
Docherty
John P
JP
Fisher
William
W
Jensen
Peter
P
Krishnan
Parukutty
P
Mittleman
Michael
M
Olfson
Mark
M
Tricarico
Joel
J
White
Tom
T
Felton
Chip
C
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019992:Databases as Topic; D020000:Decision Support Systems, Clinical; D004346:Drug Information Services; D019317:Evidence-Based Medicine; D006801:Humans; D007902:Length of Stay; D009518:New York; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011569:Psychiatric Status Rating Scales; D011785:Quality Assurance, Health Care; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents