Electronic health record feedback to improve antibiotic prescribing for acute respiratory infections.

摘要: OBJECTIVE To examine whether the Acute Respiratory Infection (ARI) Quality Dashboard, an electronic health record (EHR)-based feedback system, changed antibiotic prescribing. STUDY DESIGN Cluster randomized, controlled trial. METHODS We randomly assigned 27 primary care practices to receive ARI Dashboard or usual care. The outcome was intent-to-intervene prescribing rate for visits. also compared between users and nonusers. RESULTS During 9-month intervention, there no difference intervention control in all visits (47% vs 47%; P = .87), antibiotic-appropriate (65% 64%; .68), non–antibiotic-appropriate (38% 40%; .70). Among 258 clinicians, 72 (28%) used at least once. These clinicians had a lower overall (42% 50% nonusers; .02). This due less non-antibiotic-appropriate ARIs (32% 43%; .004), including nonstreptococcal pharyngitis (31% 41%; .01) nonspecific upper respiratory infections (19% 34%; .01). CONCLUSIONS not associated with change ARIs, although when used, it improved EHR-based quality reporting, as part of "meaningful use," may improve absence other changes practice.