Previously submitted to: JMIR Medical Education (no longer under consideration since Jan 28, 2025)
Date Submitted: Jul 18, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Reach, Adoption and Sustainability of a Mobile Clinical Decision Support Tool Paired with a National Quality Improvement Project Targeting Emergency Department Febrile Infant Management
ABSTRACT
Background:
Deploying electronic clinical decision support (ECDS) using a mobile app (mECDS) has shown the potential to be a viable method of overcoming scalability and sustainability limitations.
Objective:
We aimed to determine, during and post an associated project, whether mECDS tool use (1) increased over time, 2) spread to other areas, 3) differed between aress with and without project sites, 4) was associated with other corresponding geospatial and temporal factors.
Methods:
In 2016, our team released a free mECDS as part of a national multi-site project. For this study, we evaluated trends in weekly mECDS use: 1) metric related screen views (MetricHits), 2) unique designated market areas (DMA) where the mECDS was used (UniqueDMAs), 3) density of use or MetricHits/UniqueDMAs (HitsPerDMA). Linear regressions were performed for each use measure across three time periods (during the project, 1-year post, 2-years post). Models were alo stratified by DMA site status.
Results:
Strong growth in the number of UniqueDMAs and MetricHits occurred during the period of 1-year post and continued to be stable 2-years post. HitsPerDMA had stronger growth in DMAs with a site. MetricHits were higher in DMAs with a larger population, more sites, more children’s hospitals, and in the summer versus winter months.
Conclusions:
Sustained temporal and geospatial increases in mECDS app usage were found contrary to more rapid drop offs in post-project ECDS usage found by others. Further research is needed to determine the factors driving mECDS use and its impact on clinical practice and patient outcomes.
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