A real-time electronic CDS for pneumonia (ePNa) identifies possible pneumonia patients, measures severity and antimicrobial resistance risk, and then recommends disposition, antibiotics, and microbiology studies. Use is voluntary, and clinicians may modify treatment recommendations. ePNa was associated with lower mortality in emergency department (ED) patients versus usual care (Annals EM 66:511). We adapted ePNa for the Cerner EHR, and implemented it across Intermountain Healthcare EDs (Utah, USA) throughout 2018. We introduced ePNa through didactic, interactive presentations to ED clinicians; follow-up visits identified barriers and facilitators to use. Email reminded clinicians and answered questions. Hospital admitting clinicians encouraged ePNa use to smooth care transitions. Audit-and-feedback measured utilization, showing variations from best practice when ePNa and associated electronic order sets were not used. Use was initially low, but gradually increased especially at larger hospitals. A user-friendly interface, frequent reminders, audit-and-feedback, a user survey, a nurse educator, and local physician champions are additive towards implementation success.

Learning Objective: 1) Understand successful approaches to adoption of electronic clinical decision support (ePNa) for emergency department clinicians
2) Evaluate methods of receiving user feedback regarding ePneumonia and applying suggestions to improve its functionality
3) Evaluate methods for measuring utilization of electronic clinical decision support


Nathan Dean (Presenter)
Intermountain Medical Center and the University of Utah

Caroline Vines, Intermountain Medical Center
Jenna Rubin, Intermountain Medical Center
Dave Collingridge, Intermountain Healthcare
Mark Mankivsky, Cerner Corporation
Raj Srivastava, Intermountain Healthcare
Barbara Jones, University of Utah
Kathryn Kuttler, Intermountain Healthcare
Missy Walker, Utah Valley Regional Medical Center
Brandon Webb, Intermountain Healthcare
Nathan Jenson, Southwest Emergency Physicians
Todd Allen, Intermountain Healthcare Delivery Institute
Peter Haug, Intermountain Healthcare and the University of Utah, Salt Lake City, UT

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