Provider-Focused Intervention to Promote Comprehensive Screening for Adolescent Idiopathic Scoliosis by Primary Care Pediatricians

Abstract

Screening can detect adolescent idiopathic scoliosis (AIS). The objective was to determine if computer-based simulation (CBS) and computerized clinical decision-support systems (CCDSS) would improve primary care providers’ AIS screening exams as noted in their documentation. All participants received AIS screening CBS training. Participants were then randomized to receive either CCDSS when an eligible patient was seen (intervention arm) or no further intervention (comparison arm). Eligible patients’ documentation was analyzed looking for a complete AIS screening exam. Over the span of 17 weeks, 1051 eligible patients were seen; 468 by providers in the intervention arm, 583 in the comparison arm. In all, 292/468 (62%) of eligible patients seen in the intervention arm and 0/583 (0%) in the comparison arm had a complete AIS screening exam documented. Compared with single CBS training alone, repeated exposure to CCDSS after CBS training resulted in improved documentation of the screening exam for AIS.