Early identification of child maltreatment is critical to decrease morbidity and mortality. Over the past 8 years, Safar Center Associate Director Rachel Berger, MD, MPH, and her team have developed an EHR-embedded child abuse clinical decision support (CA-CDS) system which helps medical providers identify, evaluate and report suspected child maltreatment. This CA-CDS is now used in more than 10 health care systems with three different EHRs – Cerner, Epic and Allscripts. Our goal is for CA-CDS to become a standard part of the EHR. The objectives of this recently funded PCORI project “Addressing Barriers to Broad Dissemination of EHR-embedded Child Abuse Clinical Decision Support” are to address two of the barriers to this long-term goal. First, providers don’t always follow the recommendations of the CA-CDS (e.g., they override appropriate recommendations to evaluate for abuse). Second, it is challenging for hospitals to evaluate how well the CA-CDS is working.
To address these barriers, Dr. Berger will be collaborating with a behavioral economist who has expertise changing physician behavior to improve end-use engagement with the CA-CDS systems in multiple hospital systems. They will also work with IT experts to better understand the barriers to developing a data warehouse report (DWR) which is essential to evaluating the impact and efficacy of the CA-CDS. This 2-year grant will start in Dec. 2021. Congratulations to Dr. Berger and her team.