Enhancing an Existing Clinical Information System to Improve Study Recruitment and Census Gathering Efficiency

Overview

Journal AMIA Annu Symp Proc

Specialty Medical Informatics

Date 2010 Mar 31

PMID 20351902

Citations 9

Authors

Flory L Nkoy

Doug Wolfe

Joseph W Hales

Gena Lattin

Maryann Rackham

Christopher G Maloney

Affiliations

Soon will be listed here.

Abstract

Information technology can improve healthcare efficiency. We developed and implemented a simple and inexpensive tool, the "Automated Case Finding and Alerting System" (ACAS), using data from an existing clinical information system to facilitate identification of potentially eligible patients for clinical trials and patient encounters for billing purposes. We validated the ACAS by calculating the level of agreement in patient identification with data generated from manual identification methods. There was substantial agreement between the two methods both for clinical trial (kappa:0.84) and billing (kappa:0.97). Automated identification occurred instantaneously vs. about 2 hours/day for clinical trial and 1 hour 10 minutes/day for billing, and was inexpensive ($98.95, one time fee) compared to manual identification ($1,200/month for clinical trial and $670/month for billing). Automated identification was more efficient and cost-effective than manual identification methods. Repurposing clinical information beyond their traditional use has the potential to improve efficiency and decrease healthcare cost.

Citing Articles

Piloting an automated clinical trial eligibility surveillance and provider alert system based on artificial intelligence and standard data models.

Meystre S, Heider P, Cates A, Bastian G, Pittman T, Gentilin S BMC Med Res Methodol. 2023; 23(1):88.

PMID: 37041475 PMC: 10088225. DOI: 10.1186/s12874-023-01916-6.

Using passive extraction of real-world data from eConsent, electronic patient reported outcomes (ePRO) and electronic health record (EHR) data loaded to an electronic data capture (EDC) system for a multi-center, prospective, observational study in....

Senerchia C, Ohrt T, Payne P, Cheng S, Wimmer D, Margolin-Katz I Contemp Clin Trials Commun. 2022; 28:100920.

PMID: 35573388 PMC: 9097692. DOI: 10.1016/j.conctc.2022.100920.

Effectiveness and cost of recruiting healthy volunteers for clinical research studies using an electronic patient portal: A randomized study.

Samuels M, Schuff R, Beninato P, Gorsuch A, Dursch J, Egan S J Clin Transl Sci. 2018; 1(6):366-372.

PMID: 29707259 PMC: 5916095. DOI: 10.1017/cts.2018.5.

Increasing the efficiency of trial-patient matching: automated clinical trial eligibility pre-screening for pediatric oncology patients.

Ni Y, Wright J, Perentesis J, Lingren T, Deleger L, Kaiser M BMC Med Inform Decis Mak. 2015; 15:28.

PMID: 25881112 PMC: 4407835. DOI: 10.1186/s12911-015-0149-3.

Automated clinical trial eligibility prescreening: increasing the efficiency of patient identification for clinical trials in the emergency department.

Ni Y, Kennebeck S, Dexheimer J, McAneney C, Tang H, Lingren T J Am Med Inform Assoc. 2014; 22(1):166-78.

PMID: 25030032 PMC: 4433376. DOI: 10.1136/amiajnl-2014-002887.

References

Fuchs V . Reforming US health care: key considerations for the new administration. JAMA. 2009; 301(9):963-4. DOI: 10.1001/jama.2009.248. View

Breitfeld P, Weisburd M, Overhage J, Sledge Jr G, Tierney W . Pilot study of a point-of-use decision support tool for cancer clinical trials eligibility. J Am Med Inform Assoc. 1999; 6(6):466-77. PMC: 61390. DOI: 10.1136/jamia.1999.0060466. View

Procuniar M, Murphy S . Intuitive information technology: enhancing clinician efficiency. AMIA Annu Symp Proc. 2008; :1247-8. View

Woolhandler S, Himmelstein D . The deteriorating administrative efficiency of the U.S. health care system. N Engl J Med. 1991; 324(18):1253-8. DOI: 10.1056/NEJM199105023241805. View

Kaufman J, Eiron I, Deen G, Ford D, Smith E, Knoop S . From regional healthcare information organizations to a national healthcare information infrastructure. Perspect Health Inf Manag. 2007; 2:10. PMC: 2047316. View

Nkoy F, Petersen S, Matheny Antommaria A, Antommaria A, Maloney C . Validation of an electronic system for recording medical student patient encounters. AMIA Annu Symp Proc. 2008; :510-4. PMC: 2655951. View

Embi P, Jain A, Clark J, Harris C . Development of an electronic health record-based Clinical Trial Alert system to enhance recruitment at the point of care. AMIA Annu Symp Proc. 2006; :231-5. PMC: 1560758. View

DCruz M, Welter T . Major trends affecting hospital payment. Healthc Financ Manage. 2008; 62(1):52-8, 60. View

Carlson R, Tu S, Lane N, Lai T, Kemper C, Musen M . Computer-based screening of patients with HIV/AIDS for clinical-trial eligibility. Online J Curr Clin Trials. 1995; Doc No 179:[3347 words; 32 paragraphs]. View

10.

Noffsinger R, Chin S . Improving the delivery of care and reducing healthcare costs with the digitization of information. J Healthc Inf Manag. 2000; 14(2):23-30. View

11.

Bodenheimer T . High and rising health care costs. Part 1: seeking an explanation. Ann Intern Med. 2005; 142(10):847-54. DOI: 10.7326/0003-4819-142-10-200505170-00010. View

12.

Hadley J, Zuckerman S, Iezzoni L . Financial pressure and competition. Changes in hospital efficiency and cost-shifting behavior. Med Care. 1996; 34(3):205-19. DOI: 10.1097/00005650-199603000-00002. View

13.

Maloney C, Wolfe D, Gesteland P, Hales J, Nkoy F . A tool for improving patient discharge process and hospital communication practices: the "Patient Tracker". AMIA Annu Symp Proc. 2008; :493-7. PMC: 2655791. View

14.

Oldham J . Achieving large system change in health care. JAMA. 2009; 301(9):965-6. DOI: 10.1001/jama.2009.228. View

15.

Afrin L, Oates J, Boyd C, Daniels M . Leveraging of open EMR architecture for clinical trial accrual. AMIA Annu Symp Proc. 2004; :16-20. PMC: 1480210. View

16.

Weiner D, Butte A, Hibberd P, Fleisher G . Computerized recruiting for clinical trials in real time. Ann Emerg Med. 2003; 41(2):242-6. DOI: 10.1067/mem.2003.52. View

17.

VanDeusen Lukas C, Holmes S, Cohen A, Restuccia J, Cramer I, Shwartz M . Transformational change in health care systems: an organizational model. Health Care Manage Rev. 2007; 32(4):309-20. DOI: 10.1097/01.HMR.0000296785.29718.5d. View

18.

Dugas M, Lange M, Berdel W, Muller-Tidow C . Workflow to improve patient recruitment for clinical trials within hospital information systems - a case-study. Trials. 2008; 9:2. PMC: 2253503. DOI: 10.1186/1745-6215-9-2. View

19.

Bentley T, Effros R, Palar K, Keeler E . Waste in the U.S. Health care system: a conceptual framework. Milbank Q. 2009; 86(4):629-59. PMC: 2690367. DOI: 10.1111/j.1468-0009.2008.00537.x. View

20.

McVeigh F, Tarbett A, Betts A, Boal T . Efficiency of automation and electronic health records in optometric practice. Optometry. 2007; 79(1):43-9. DOI: 10.1016/j.optm.2007.06.013. View