P3B409: PEDSGUIDE! Bringing Clinical Decision Support to the Palm of Your Hand!

Purpose/Objectives: It is well accepted that care of pediatric patients can be inconsistent in non-pediatric settings. Frequently children with conditions that require urgent or life saving care receive their initial frontline care from health care personnel that infrequently care for children and therefore frequently lack experience and up to date knowledge facilitating evidence based care. Examples include appearing infants with fever less than 3 months of age, burn injury, acute head injury, brief resolved unexplained events, and diabetes and diabetic ketoacidosis. If this is combined with the rapid changes in evidence based practice and translation of new algorithms and clinical practice guidelines, it can be difficult for those trained in pediatrics to keep up let alone those providers who often see children less frequently. Clinical practice guidelines in algorithmic format are also difficult to follow and access. Clinical decision tree formats require higher cognitive loads. We sought to transform these formats and bring conditional structure to the decision making through a mobile application platform that facilitates both the rapid access to information and that facilitates the frontline care for all providers in an effort to improve frontline care for children with common urgent/emergent conditions.

Design/Methods: A mobile device application was designed with a modular format. The app is free and available on iOS and android devices. The modules currently included in the application include Febrile infants, Pediatric resuscitation and acute burn management, Acute diabetes and DKA management. Acute asthma management, and BRUE. Conditional workflows were designed to follow clinical practice guideline algorithms. User centered design was undertaken through human factors heuristics, usability and user experience in an effort to optimize module design. A data warehouse was constructed in an effort to understand demographics of use, roles of users, and frequency of use of the various modules in an effort to drive ongoing development.

Results: The data is preliminary as the data warehouse was only recently completed. The preliminary data demonstrate just over 55,000 application home screen accesses in the 21month period of the graph. In this period BRUE was accessed the most. Diabetes had the next most frequent views.
With finalization of the data warehouse and major update being launched, more granular data is expected for the fall presentation.

Conclusion/Discussion: Pedsguide is a mobile application with the goal to improve frontline care of children through quick access to clinical decision support on a national level and Improve collaboration in translating up to date research. Expand knowledge in how mobile device or just in time clinical decision support can impact outcomes. In this early data we demonstrate its uptake and use. Further data will help demonstrate what roles are represented in the users from learners to pediatric experts. Development is ongoing with planned new modules.