Electronic Health Record Clinical Decision Support Tool Improves Ambulatory Reflux Testing Practices.

INTRODUCTION

Performing reflux testing on acid suppression without a confirmed diagnosis of gastroesophageal reflux disease conflicts with best practice recommendations and reduces diagnostic utility. We assessed whether clinical decision support (CDS) improves ordering practices.

METHODS

Quality improvement methods were used to develop and test the effectiveness of a novel CDS tool.

RESULTS

The testing rate on acid suppression decreased (30.9% vs 8.4%; P < 0.01), best practice concordance increased (16.4% vs 60.0%; P < 0.001), and more clinical management changes occurred (23.1% vs 60.0%; P = 0.01) after CDS deployment.

DISCUSSION: Use of CDS for reflux testing improves ordering practices and meaningful changes clinical management.