ePneumonia: Development of an Electronic Clinical Decision Support System for Community-Onset Pneumonia
1 other identifier
observational
10,000
1 country
17
Brief Summary
The investigators plan to further develop a prototype, evidence-based, electronic clinical decision support system (CDSS) for pneumonia care (ePneumonia) with interoperability across Electronic Health Records in order to improve clinical outcomes and reduce healthcare resource utilization. The specific aims of this study are to evaluate the usability of ePneumonia adapted for Cerner and its impact on clinical, patient-centered and healthcare resource utilization outcomes in a stepped-wedge implementation study in 16 hospital emergency departments (EDs) across the Intermountain Healthcare integrated health system.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started Nov 2017
Typical duration for all trials
17 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
November 22, 2017
CompletedFirst Submitted
Initial submission to the registry
November 24, 2017
CompletedFirst Posted
Study publicly available on registry
November 30, 2017
CompletedPrimary Completion
Last participant's last visit for primary outcome
June 20, 2019
CompletedStudy Completion
Last participant's last visit for all outcomes
December 31, 2019
CompletedOctober 8, 2020
October 1, 2020
1.6 years
November 24, 2017
October 5, 2020
Conditions
Outcome Measures
Primary Outcomes (1)
30 day all-cause mortality
mortality within 30 days of initial ED visit
30 days
Secondary Outcomes (7)
Matching of patient disposition from the ED with ePneumonia recommendation
End of initial ED visit, <24 hours after ED arrival
Accuracy of Drug Resistance in Pneumonia (DRIP) score within the ePneumonia logic to predict Multi-Drug Resistant (MDR) pathogens
30 days
Antibiotic utilization rates, in terms of appropriateness of spectrum
30 days
Rate of secondary hospital admission within 7 days for ED patients whose initial disposition was outpatient care
7 days
Direct costs
Duration of hospital stay, censored at 90 days
- +2 more secondary outcomes
Study Arms (2)
ED Patients treated using ePneumonia CDS
ED patients with community-acquired pneumonia treated in ED's after roll out of ePneumonia
Usual care
ED patients with pneumonia receiving usual care without electronic CDS
Interventions
ePneumonia clinical decision support system for community-onset pneumonia
Eligibility Criteria
(1) All patients ≥ 18 years who are identified by either (2a) ICD-10 codes for pneumonia; or acute respiratory failure or sepsis with secondary pneumonia codes or (2b) clinician completion of ePneumonia for Cerner. Intermountain Healthcare physicians
You may qualify if:
- All patients ≥ 18 years who are identified by either (2a) ICD-10 codes for pneumonia; or acute respiratory failure or sepsis with secondary pneumonia codes or (2b) clinician completion of ePneumonia for Cerner.
- Intermountain Healthcare physicians working in the 16 ED's
You may not qualify if:
- Patients without radiographic confirmation of pneumonia
- subsequent episodes of pneumonia within the study period, so as not to over-represent patients with recurrent pneumonia caused by recurrent aspiration or structural lung disease, and
- immunosuppressed patients, such as those with AIDS.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (17)
Cassia Regional Hospital
Burley, Idaho, 83318, United States
American Fork Hospital
American Fork, Utah, 84003, United States
Cedar City Hospital
Cedar City, Utah, 84721, United States
Delta Community Hospital
Delta, Utah, 84624, United States
Fillmore Hospital
Fillmore, Utah, 84631, United States
Heber Valley Hospital
Heber City, Utah, 84032, United States
Logan Regional Hospital
Logan, Utah, 84341, United States
Sanpete Valley Hospital
Mount Pleasant, Utah, 84647, United States
Intermountain Medical Center
Murray, Utah, 84157, United States
McKay-Dee Hospital
Ogden, Utah, 84403, United States
Orem Community Hospital
Orem, Utah, 84057, United States
Garfield Memorial Hospital
Panguitch, Utah, 84759, United States
Park City Medical Center
Park City, Utah, 84060, United States
Utah Valley Hospital
Provo, Utah, 84604, United States
Sevier Valley Hospital
Richfield, Utah, 84701, United States
Dixie Regional Medical Center
St. George, Utah, 84790, United States
Bear River Hospital
Tremonton, Utah, 84337, United States
Related Publications (1)
Dean NC, Vines CG, Carr JR, Rubin JG, Webb BJ, Jacobs JR, Butler AM, Lee J, Jephson AR, Jenson N, Walker M, Brown SM, Irvin JA, Lungren MP, Allen TL. A Pragmatic, Stepped-Wedge, Cluster-controlled Clinical Trial of Real-Time Pneumonia Clinical Decision Support. Am J Respir Crit Care Med. 2022 Jun 1;205(11):1330-1336. doi: 10.1164/rccm.202109-2092OC.
PMID: 35258444DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Nathan Dean, MD
Intermountain Health Care, Inc.
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Section Chief of Pulmonary and Critical Care Medicine
Study Record Dates
First Submitted
November 24, 2017
First Posted
November 30, 2017
Study Start
November 22, 2017
Primary Completion
June 20, 2019
Study Completion
December 31, 2019
Last Updated
October 8, 2020
Record last verified: 2020-10
Data Sharing
- IPD Sharing
- Will not share