Child Health Improvement Through Computer Automation - Child Neurology (CHICA-CN) Evaluation

NCT05173506 | Completed

• 1 other identifier: IRB00078610
• Study Type: observational
• Target: 455
• Locations: 1 country
• Sites: 1

Brief Summary

The study will evaluate a computer decision support system for child neurology, Child Health Improvement through Computer Automation - Child Neurology (CHICA-CN) using patient chart review, family phone surveys, and physician interviews in a before-after study design.

Conditions

Neurologic Disorder

Keywords

Quality of Care; Child Health Improvement

Outcome Measures

Primary Outcomes (7)

• Chart Abstraction Outcomes - Transitions of Care

  Transitions of Care - the number of charts that document that the service was provided divided by the number of charts reviewed

  Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN

• Chart Abstraction Outcomes - Rescue Seizure Therapy for Children with Epilepsy

  Rescue Seizure Therapy for Children with Epilepsy - the number of charts that document that the service was provided divided by the number of charts reviewed

  Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN

• Chart Abstraction Outcomes - Genetic Testing for Global Developmental Delay

  Genetic Testing for Global Developmental Delay - the number of charts that document that the service was provided divided by the number of charts reviewed

  Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN

• Chart Abstraction Outcomes - Adolescent Depression Screening

  Adolescent Depression Screening - the number of charts that document that the service was provided divided by the number of charts reviewed

  Visits will be extracted for the year before implementation of CHICA-CN and for a one year period after implementation of CHICA-CN

• Physician-patient communication Survey Score

  Communication subscale of the Ambulatory Care Experiences (ACE) Survey - includes 4 items like "How often did your personal doctor explain things in a way that was easy to understand" or "How would you rate your personal doctor's knowledge of your medical history." - Single score (0-12), higher score indicates better communication.

  Eligible patients will be identified as they have encounters, starting 6 months after implementation of CHICA-CN and continuing for 12 months, assessed for the identified visit, within 2 weeks of the visit

• Patient engagement Survey Score

  Patient Activation Measure Short Form (PAM) - 13 item scale assesses whether the parent believes an active role in the child's care is important; if the parent has the confidence and knowledge to take action, e.g., medications, bringing concerns to the provider; if the parent has taken action, e.g., lifestyle changes, to improve child's health; and whether the parent stays on course under stress, e.g., being able to handle child's health condition at home. 13 items, single score (0-39), higher score indicates greater patient/parent engagement.

  Eligible patients will be identified as they have encounters, starting 6 months after implementation of CHICA-CN and continuing for 12 months, assessed for the identified visit, within 2 weeks of the visit

• Physician Satisfaction Survey

  Clinician user satisfaction measures, including perceived value of the system and ease of use in general and as regards individual clinical issues. Surveys will be administered to physicians and clinic staff who used CHICA-CN. The survey includes a series of statements with which the respondent will mark their level of agreement on a Likert scale. There is no summary score, but we will calculate and report a mean, median, and range for each item.

  After one year of of clinicians using CHICA-CN

Study Arms (4)

Adolescent Depression Screening

* \> 3 visits to clinic * Diagnosis of epilepsy - International Classification of Diseases, Tenth Revision - Epilepsy and recurrent seizures (ICD-10:G40) * Age \> 12 years at last visit (before CHICA-CN) Computer assistant depression screening and management

Other: Computer decision support for physician

Genetic Testing

* \> 3 visits to clinic * Diagnosis of global developmental delay - International Classification of Diseases, Tenth Revision - autistic disorder (ICD-10: F84) * Age \< 6 years at last visit (before CHICA-CN) Computer reminders to test for genetic disorders

Other: Computer decision support for physician

Rescue seizure therapy

* \> 3 visits to clinic * Diagnosis of epilepsy - International Classification of Diseases, Tenth Revision - Epilepsy and recurrent seizures (ICD-10: G40) * Age \< 18 years at last visit (before CHICA-CN) Computer reminders to prescribe and adjust rescue anti-seizure medications

Other: Computer decision support for physician

Adolescent Transition

* \> 3 visits to clinic * Age \> 13 years at last visit (before CHICA-CN) Computer supported screening and counseling regarding transition to adult care

Other: Computer decision support for physician

Interventions

Computer decision support for physician OTHER

The Child Health Improvement through Computer Automation - Child Neurology (CHICA-CN) system will screen patients for needed services and provide reminders to physicians to provide the needed services.

Adolescent Depression Screening; Adolescent Transition; Genetic Testing; Rescue seizure therapy

Eligibility Criteria

• Age: Up to 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

All children under 18 years of age who attend one of two participating child neurology clinics who qualify for one of the four cohorts and who have at least three visits to that clinic and at least one visit during the study period

You may not qualify if:

• N/A

Sponsors & Collaborators

• Wake Forest University Health Sciences: lead
• Norton Healthcare: collaborator
• Indiana University: collaborator
• Child Neurology Foundation: collaborator

Study Sites (1)

Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157, United States

Location

MeSH Terms

Conditions

Nervous System Diseases

Interventions

Physicians

Intervention Hierarchy (Ancestors)

Health Personnel; Health Care Facilities Workforce and Services

Study Officials

• Jaclyn M Martindale, DO

  Wake Forest University Health Sciences

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 17, 2021
• First Posted: December 30, 2021
• Study Start: August 18, 2022
• Primary Completion: August 30, 2024
• Study Completion: September 17, 2024
• Last Updated: October 17, 2024

Record last verified: 2024-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)