P2.074: Utilizing Electronic Health Record Clinical Decision Support​ to Improve Pediatric Preventative Care

Purpose/Objectives: The EPIC electronic health record (EHR) system includes clinical decision support tools such as Care Gaps/Health Maintenance which provides preventative medicine recommendations (e.g., vaccinations) based on a patient’s medical record. Provider utilization of available tools within electronic health record (EHR) systems can increase rates of age-appropriate screening recommendations. This quality improvement (QI) project set out to educate pediatric residents in the utilization of the Care Gap tool and increase their confidence in their knowledge of preventative health recommendations with a goal to increase rates of age-appropriate preventative health screenings.

Design/Methods: The plan-do-study-act approach was used in developing and monitoring the project. The planning phase included assessing the extent and accuracy of preventative medicine recommendations offered by the Care Gaps tool. A pre-survey was then designed and administered to pediatric residents to assess their current knowledge and rate of use of EHR Care Gaps, along with their confidence in preventative health recommendations. Residents were then educated on navigating, utilizing, and troubleshooting patient Care Gaps by a resident member of the QI team. A post-survey was administered 3 months following the education to assess for improvement to residents’ use of Care Gaps and if this impacted their confidence in preventative health recommendations.

Results: Of 21 (92%) residents who completed the pre-survey, 67% were aware of Care Gaps. Fifty percent of the 21 respondents reported never using Care Gaps to track preventative health measures, and 71% of them had not used it for chronic disease populations. Twenty-four percent of the residents were confident or very confident in their knowledge of preventative health recommendations for general pediatrics and 14% for the chronic disease populations.
Of the 18 (75%) residents who responded to the post-survey, 89% were aware of Care Gaps. Usage of Care Gaps increased with 83% of respondents using it for preventative health tracking and 72% using it for special pediatric populations. Confidence in knowledge improved for general pediatrics (39%), though it remained similar for chronic disease populations (16%).

Conclusion/Discussion: Post-survey findings demonstrated an increase in pediatric resident use of the Care Gap EHR tool along with an overall increase in resident confidence in preventive health care recommendations following a peer-to-peer education session. The team will now focus to increase lipid screenings in obese patients aged 2-9 per the American Academy of Pediatrics recommendations. We plan on doing so by educating the pediatric residents on the current screening guidelines and building appropriate Care Gap recommendations for the residents to utilize in the EHR.