Improving Quality by Maintaining Accurate Problems in the Electronic Health Record

About the study

The overall goal of the IQ-MAPLE project is to improve the quality of care provided to
patients with several heart, lung and blood conditions by facilitating more accurate and
complete problem list documentation. In the first aim, the investigators will design and
validate a series of problem inference algorithms, using rule-based techniques on structured
data in the electronic health record (EHR) and natural language processing on unstructured
data. Both of these techniques will yield candidate problems that the patient is likely to
have, and the results will be integrated. In Aim 2, the investigators will design clinical
decision support interventions in the EHRs of the four study sites to alert physicians when a
candidate problem is detected that is missing from the patient’s problem list – the clinician
will then be able to accept the alert and add the problem, override the alert, or ignore it
entirely. In Aim 3, the investigators will conduct a randomized trial and evaluate the effect
of the problem list alert on three endpoints: alert acceptance, problem list addition rate
and clinical quality.