title: Use of a Web-based clinical decision support system to improve abdominal aortic aneurysm screening in a primary care practice.
abstract: OBJECTIVE
  The United States Preventive Services Task Force recommends a one-time screening for abdominal aortic aneurysm (AAA) with ultrasonography for men aged 65 to 75 years who have ever smoked. However, despite a mortality rate of up to 80% for ruptured AAAs, providers order the screening for a minority of patients. We sought to determine the effect of a Web-based point-of-care clinical decision support system on AAA screening rates in a primary care practice.
  
  
  METHODS
  We conducted a retrospective review of medical records of male patients aged 65 to 75 years who were seen at any of our practice sites in 2007 and 2008, before and after implementation of the clinical decision support system.
  
  
  RESULTS
  Overall screening rates were 31.36% in 2007 and 44.09% in 2008 (P-value: <0.001). Of patients who had not had AAA screening prior to the visit, 3.22% completed the screening after the visit in 2007, compared with 18.24% in 2008 when the clinical support system was implemented, 5.36 times improvement (P-value: <0.001).
  
  
  CONCLUSIONS
  A Web-based clinical decision support for primary care physicians significantly improved delivery of AAA screening of eligible patients. Carefully developed clinical decision support systems can optimize care delivery, ensuring that important preventive services are delivered to eligible patients.
authors.affiliation: Division of Primary Care Internal Medicine, Center for Innovation, Department of Family Medicine and Information Technology, Mayo Clinic, Rochester, MN 55905, USA. rajeev@mayo.edu
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chaudhry
authors.forename: Sidna M
authors.initials: SM
authors.lastname: Tulledge-Scheitel
authors.forename: Doug A
authors.initials: DA
authors.lastname: Parks
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Angstman
authors.forename: Lindsay K
authors.initials: LK
authors.lastname: Decker
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stroebel
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis* / Q000000981:diagnostic imaging; D020000:Decision Support Systems, Clinical; D019468:Disease Management; D006801:Humans; D020407:Internet; D008297:Male; D019095:Point-of-Care Systems; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards; D014463:Ultrasonography