Use of a clinical decision support system to increase osteoporosis screening.
BACKGROUND
In 2002, the US Preventive Services Task Force recommended routine osteoporosis screening for women aged 65 years or older. However, studies have indicated that osteoporosis remains underdiagnosed, and various methods such as the use of health information technology have been tried to increase screening rates. We investigated whether we could boost the low rates of bone mineral density testing with implementation of a point-of-care clinical decision support system in our primary care practice.


METHODS
We retrospectively reviewed the medical records of female patients eligible for osteoporosis screening who had no prior bone mineral density test who were seen at our primary care practice sites in 2007 or 2008 (before and after implementation of a point-of-care clinical decision support system).


RESULTS
Overall, screening rates were 80.1% in 2007 and 84.1% in 2008 (P < 0.001). Of patients who did not have osteoporosis screening before the visit, 5.87% completed the screening after the visit in 2007, compared with 9.79% in 2008 (when the clinical support system was implemented), a 66.7% improvement (P = 0.025).


CONCLUSIONS
Clinical decision support for primary care doctors significantly improved osteoporosis screening rates among eligible women. Carefully designed clinical decision support systems can optimize care delivery, ensuring that important preventive services such as osteoporosis screening for patients at risk for fracture are performed while unnecessary testing is avoided.
DeJesus
Ramona S
RS
Division of Primary Care Internal Medicine, Center for Innovation, Mayo Clinic, Rochester, Minnesota 55905, USA. dejesus.ramona@mayo.edu
Angstman
Kurt B
KB
Kesman
Rebecca
R
Stroebel
Robert J
RJ
Bernard
Matthew E
ME
Scheitel
Sidna M
SM
Hunt
Vicki L
VL
Rahman
Ahmed S
AS
Chaudhry
Rajeev
R
D000368:Aged; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008485:Medical Audit; D010024:Osteoporosis / Q000175:diagnosis*; D012189:Retrospective Studies; D014481:United States