The Impact of EHR-Alerts on the Use of an EHR-Integrated Clinical Decision Support Pathway and the Use of High Flow Nasal Cannula in Bronchiolitis

What this Trial Is About

Researchers are studying how different types of alerts in Electronic Health Records (EHR) affect doctors' use of clinical guidelines for treating bronchiolitis in young children. Bronchiolitis is a common viral illness affecting infants and toddlers under 2 years old, often leading to hospitalization. The study aims to find out if these alerts increase use of evidence-based care and reduce unnecessary treatments like low-value High Flow Nasal Cannula (HFNC) use, which can lead to longer hospital stays and higher costs. The study randomly assigns children under 2 years old who come to the hospital with bronchiolitis indicators into three groups. One group’s doctors receive no EHR alert, the second group’s doctors receive an interruptive alert requiring interaction, and the third group’s doctors see a non-interruptive visual alert. All groups continue to have access to the evidence-based clinical guideline embedded in the EHR. Researchers will compare guideline use between these groups and assess how guideline use affects HFNC use and other care elements. Participants will receive usual hospital care during the study. Researchers will measure how often doctors use the EHR clinical decision support tool from the time of enrollment until the end of the emergency visit or hospital stay (up to 4 days). They will also look at orders placed through the tool and impacts on care outcomes like ICU admission, length of hospital stay, and readmissions. This study is led by Johns Hopkins University and aims to improve care quality for children with bronchiolitis.

Evaluation of the Impact of EHR-Alerts on Clinical Decision Support Pathway Use in Bronchiolitis, and the Impact of Pathway Use on the Prescription of High Flow Nasal Cannula and Other Elements of High Value Care.