Adaptation and Pilot Implementation of ePNa Clinical Decision Support for Utah Urgent Care Clinics
Pneumonia
About this trial
This is an interventional health services research trial for Pneumonia
Eligibility Criteria
Inclusion Criteria:
- All patients ≥ 12 years of age with pneumonia: defined by the J-18.X pneumonia code or acute respiratory failure or sepsis with secondary pneumonia codes
Survey All physicians and advanced practice clinicians who are employed and actively seeing patients in the 4 Utah Valley Instacares
Exclusion Criteria:
- Patients without radiographic confirmation of pneumonia
- Subsequent episodes of pneumonia within 12 months (so as not to over-represent patients with recurrent pneumonia caused by recurrent aspiration or structural lung disease).
Survey No providers will be excluded from the survey invitation
Sites / Locations
- American Fork Instacare
- Layton Instacare
- Lehi Instacare
- Intermountain Medical Center
- North Ogden Instacare
- North Orem Instacare
- Utah Valley Instacare
- Herefordshire Instacare
- Saratoga Springs Instacare
- South Ogden Instacare
- Springville Instacare
Arms of the Study
Arm 1
Arm 2
Other
Other
Physician Survey
Adapt ePNa-CheXED for InstaCares
A modified version of a previously validated REDCap questionnaire will be administered to Instacare clinicians in the cluster where ePNa-CheXED was deployed via email at 6 months after ePNa-CheXED implementation. Our questionnaire includes questions on respondent demographics and Likert-style questions about respondents' experiences with ePNa. We will validate our modified questionnaire by calculating component loadings and Cronbach Alphas (i.e., internal consistency) of Likert questions loading onto the same components
Adapt ePNa-CheXED for Instacares and after in silico testing, pilot it among "super user" clinicians during Instacare shifts and assess its usability. ePNa needs adaptation for more limited patient data available in Instacare clinics, calibration of severity measures for lower observed mortality, and a chest imaging prompt in patients with pneumonia signs and symptoms. ePNa-CheXED will incorporate Stanford University's artificial intelligence CheXED model to provide electronic classification of chest images in <1 second for elements of pneumonia diagnosis and treatment (radiographic pneumonia, single vs multiple lobes, and pleural effusion).