title: Leveraging electronic tablets for general pediatric care: a pilot study.
abstract: BACKGROUND
  We have previously shown that a scan-able paper based interface linked to a computerized clinical decision support system (CDSS) can effectively screen patients in pediatric waiting rooms and support the physician using evidence based care guidelines at the time of clinical encounter. However, the use of scan-able paper based interface has many inherent limitations including lacking real time communication with the CDSS and being prone to human and system errors. An electronic tablet based user interface can not only overcome these limitations, but may also support advanced functionality for clinical and research use. However, use of such devices for pediatric care is not well studied in clinical settings.
  
  
  OBJECTIVE
  In this pilot study, we enhance our pediatric CDSS with an electronic tablet based user interface and evaluate it for usability as well as for changes in patient questionnaire completion rates.
  
  
  METHODS
  Child Health Improvement through Computers Leveraging Electronic Tablets or CHICLET is an electronic tablet based user interface. It is developed to augment the existing scan-able paper interface to our CDSS. For the purposes of this study, we deployed CHICLET in one outpatient pediatric clinic. Usability factors for CHICLET were evaluated via caregiver and staff surveys.
  
  
  RESULTS
  When compared to the scan-able paper based interface, we observed an 18% increase or 30% relative increase in question completion rates using CHICLET. This difference was statistically significant. Caregivers and staff survey results were positive for using CHICLET in clinical environment.
  
  
  CONCLUSIONS
  Electronic tablets are a viable interface for capturing patient self-report in pediatric waiting rooms. We further hypothesize that the use of electronic tablet based interfaces will drive advances in computerized clinical decision support and create opportunities for patient engagement.
authors.affiliation: Pediatric Institute , Cleveland Clinic, Cleveland, OH.
authors.forename: V
authors.initials: V
authors.lastname: Anand
authors.affiliation: Childrens Health Services Research, School of Medicine, Indiana University , IN.
authors.forename: S
authors.initials: S
authors.lastname: McKee
authors.affiliation: Childrens Health Services Research, School of Medicine, Indiana University , IN.
authors.forename: T M
authors.initials: TM
authors.lastname: Dugan
authors.affiliation: Childrens Health Services Research, School of Medicine, Indiana University , IN ; Regenstrief Institute for Healthcare , IN.
authors.forename: S M
authors.initials: SM
authors.lastname: Downs
mesh_terms: D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D003201:Computers / Q000706:statistics & numerical data; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data; D006282:Health Personnel; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010372:Pediatrics / Q000379:methods*; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D014584:User-Computer Interface
keywords: CDSS; EMR; Electronic tablets; children; clinical decision support system; pediatrics
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