2024
Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physicians
2022
User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial
Melnick ER, Nath B, Dziura JD, Casey MF, Jeffery MM, Paek H, Soares WE, Hoppe JA, Rajeevan H, Li F, Skains RM, Walter LA, Patel MD, Chari SV, Platts-Mills TF, Hess EP, D'Onofrio G. User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial. The BMJ 2022, 377: e069271. PMID: 35760423, PMCID: PMC9231533, DOI: 10.1136/bmj-2021-069271.Peer-Reviewed Original ResearchConceptsOpioid use disorderUsual care armEmergency departmentUse disordersCare armPragmatic clusterClinical decision supportIntervention armRoutine emergency careSecondary implementation outcomesSeverity of withdrawalTertiary care centerClinical decision support toolInitiation of buprenorphineElectronic health record tasksElectronic health record workflowsRE-AIM frameworkElectronic health record platformsHealth record platformsClinical decision support systemElectronic health recordsVisit documentationTreatment of addictionUsual careAdult patientsClinical decision support in cardiovascular medicine
Lu Y, Melnick ER, Krumholz HM. Clinical decision support in cardiovascular medicine. The BMJ 2022, 377: e059818. PMID: 35613721, DOI: 10.1136/bmj-2020-059818.Peer-Reviewed Original ResearchConceptsCardiovascular diseaseCardiovascular careEffectiveness of CDSRisk factor modificationClinical decision support toolQuality of careClinical decision supportClinical outcomesFactor modificationHealth information technologyClinical practicePatient careDiseaseCardiovascular medicineCDS effectivenessCareEffectiveness of deliveryMissed opportunityTreatmentFailureProper evidenceHealthcare processesMedicineEvidencePrevention
2021
57 EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder
Melnick E, Casey M, Dziura J, Jeffery M, Soares W, Hoppe R. 57 EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder. Annals Of Emergency Medicine 2021, 78: s23. DOI: 10.1016/j.annemergmed.2021.09.066.Peer-Reviewed Original Research
2019
User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial
Melnick ER, Jeffery MM, Dziura JD, Mao JA, Hess EP, Platts-Mills TF, Solad Y, Paek H, Martel S, Patel MD, Bankowski L, Lu C, Brandt C, D’Onofrio G. User-centred clinical decision support to implement emergency department-initiated buprenorphine for opioid use disorder: protocol for the pragmatic group randomised EMBED trial. BMJ Open 2019, 9: e028488. PMID: 31152039, PMCID: PMC6550013, DOI: 10.1136/bmjopen-2018-028488.Peer-Reviewed Original ResearchMeSH KeywordsAdultBuprenorphineCluster AnalysisDecision Support Systems, ClinicalEmergency Service, HospitalFemaleHumansMaleMiddle AgedMulticenter Studies as TopicNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicUnited StatesYoung AdultConceptsOpioid use disorderEmergency departmentSecondary outcomesUse disordersEmergency department-initiated buprenorphineWestern Institutional Review BoardData Safety Monitoring BoardIndependent study monitorsRates of cliniciansRoutine emergency careSafety monitoring boardInstitutional review boardClinical decision support systemClinician prescribingPragmatic clusterPatient characteristicsPeer-reviewed journalsClinical decision supportPrimary outcomeED cliniciansWithdrawal symptomsOngoing treatmentPatients' willingnessMonitoring boardBuprenorphine
2017
Patient-Centered Decision Support: Formative Usability Evaluation of Integrated Clinical Decision Support With a Patient Decision Aid for Minor Head Injury in the Emergency Department
Melnick ER, Hess EP, Guo G, Breslin M, Lopez K, Pavlo AJ, Abujarad F, Powsner SM, Post LA. Patient-Centered Decision Support: Formative Usability Evaluation of Integrated Clinical Decision Support With a Patient Decision Aid for Minor Head Injury in the Emergency Department. Journal Of Medical Internet Research 2017, 19: e174. PMID: 28526667, PMCID: PMC5457532, DOI: 10.2196/jmir.7846.Peer-Reviewed Original ResearchConceptsMinor head injuryCanadian CT Head RuleClinician-patient relationshipPatient-specific riskHead injuryPatient decision aidClinical decision supportDecision supportCT useEmergency departmentPatient concernsCanadian Computed Tomography Head RuleUser interface developmentMinor head injury patientsFormative usability evaluationPatient-centered decision supportEmergency care cliniciansUser-centered designHead injury patientsClinical decision rulePatients' specific concernsIntegrated clinical decision supportTomography Head RuleInitial prototype developmentHealth information technology
2010
P61– Delphi consensus on the feasibility of translating the American College of Emergency Physicians clinical policies into computerized clinical decision support
Melnick E, Nielson J, Finnell J, Patel S, Richardson L. P61– Delphi consensus on the feasibility of translating the American College of Emergency Physicians clinical policies into computerized clinical decision support. Otolaryngology 2010, 143: 109-110. DOI: 10.1016/j.otohns.2010.04.085.Peer-Reviewed Original ResearchDelphi Consensus on the Feasibility of Translating the ACEP Clinical Policies Into Computerized Clinical Decision Support
Melnick ER, Nielson JA, Finnell JT, Bullard MJ, Cantrill SV, Cochrane DG, Halamka JD, Handler JA, Holroyd BR, Kamens D, Kho A, McClay J, Shapiro JS, Teich J, Wears RL, Patel SJ, Ward MF, Richardson LD. Delphi Consensus on the Feasibility of Translating the ACEP Clinical Policies Into Computerized Clinical Decision Support. Annals Of Emergency Medicine 2010, 56: 317-320. PMID: 20363531, DOI: 10.1016/j.annemergmed.2010.03.006.Peer-Reviewed Original ResearchConceptsACEP clinical policyClinical practice guidelinesClinical policyPractice guidelinesClinical decision supportGuideline developmentEmergency Physicians Clinical PolicyEvidence-based practice guidelinesClinical practice guideline developmentComputerized clinical decision supportComputerized clinical decision support systemsPractice guideline developmentDelphi consensus processHealth care qualityClinical decision support systemPoint of careClinicians' decisionsAmerican CollegeDelphi consensusClinical practiceConsensus documentCare qualityPhysician practicesExpert panelConsensus process