THE IMPACT ON USERS OF A WEB BASED DIAGNOSIS DECISION SUPPORT SYSTEM

Monday, October 25, 2010
Vide Lobby (Sheraton Centre Toronto Hotel)
Napoleon B. Knight, Carle Foundation Hospital, Urbana, IL

Statement of problem: To look at the overall impact on users of a web based diagnosis decision support system (Isabel).

Description of the intervention or program: Isabel, a well-known web based diagnosis decision support system, is used by several hospitals across the USA. Some of these have approved the use of Isabel for CME purposes. In order to earn CME credits while using Isabel users must complete a form that asks 5 multiple choice questions about the impact the system had on their management for that episode of use. The results of the answers to the 660 forms collected over a 16 month period have been aggregated to give a view on the generalized impact of such a tool on its users and their diagnosis decision making.

Findings to date: The answers in aggregate over 660 forms were A) In 68% of the responses Isabel was used on a specific patient case; B) In 50.5% of the cases the system confirmed the users own working diagnosis and in 17% of cases the user changed their working diagnosis; C) in 83% of cases the user thought that Isabel had helped them consider important diagnoses they had not thought of; D) In 38% of cases the user ordered an additional test and in 5.5% they ordered an additional medication; e) In 70% of cases the user thought that Isabel would increase the quality of care that the patient received

Lessons learned: These results show that the routine use of a diagnosis decision support  system, such as Isabel, could have a positive impact on diagnosis error, patient safety and quality of care.