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 patients
2020
Progress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder †
Melnick ER, Nath B, Ahmed OM, Brandt C, Chartash D, Dziura JD, Hess EP, Holland WC, Hoppe JA, Jeffery MM, Katsovich L, Li F, Lu CC, Maciejewski K, Maleska M, Mao JA, Martel S, Michael S, Paek H, Patel MD, Platts-Mills TF, Rajeevan H, Ray JM, Skains RM, Soares WE, Deutsch A, Solad Y, D’Onofrio G. Progress Report on EMBED: A Pragmatic Trial of User-Centered Clinical Decision Support to Implement EMergency Department-Initiated BuprenorphinE for Opioid Use Disorder †. Journal Of Psychiatry And Brain Science 2020, 2: e200003. PMID: 32309637, PMCID: PMC7164817, DOI: 10.20900/jpbs.20200003.Peer-Reviewed Original ResearchBuprenorphine/naloxoneOpioid use disorderClinical decision supportPragmatic trialElectronic health recordsUse disordersEmergency Department-Initiated BuprenorphineMulti-centre pragmatic trialRoutine emergency careHealthcare systemRates of EDNaloxone prescribingPilot testingSingle EDEmergency departmentPhysicians' perceptionsEmergency careMortality rateEarly identificationComputable phenotypeUnique physiciansInformed consentCare paradigmHealth recordsIntervention effectiveness
2019
An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial
Melnick ER, Holland WC, Ahmed OM, K A, Michael SS, Goldberg HS, Lagier C, D’Onofrio G, Stachowiak T, Brandt C, Solad Y. An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial. JAMIA Open 2019, 2: 434-439. PMID: 32025639, PMCID: PMC6994013, DOI: 10.1093/jamiaopen/ooz053.Peer-Reviewed Original ResearchComputerized clinical decision supportWeb applicationCDS developmentDecision supportIntegrated web applicationWeb-based solutionTwo-way messagingClinical decision supportElectronic health recordsSecurity concernsData standardsRobust sharingEHR workflowScalabilityHealth recordsInteroperabilityLocal customizationRapid integrationFuture standardsMessagingImplementationCD interventionChallengesAutomationCase studyUser-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 boardBuprenorphineComputerized Clinical Decision Support System for Emergency Department–Initiated Buprenorphine for Opioid Use Disorder: User-Centered Design
Ray JM, Ahmed OM, Solad Y, Maleska M, Martel S, Jeffery MM, Platts-Mills TF, Hess EP, D’Onofrio G, Melnick ER. Computerized Clinical Decision Support System for Emergency Department–Initiated Buprenorphine for Opioid Use Disorder: User-Centered Design. JMIR Human Factors 2019, 6: e13121. PMID: 30810531, PMCID: PMC6414819, DOI: 10.2196/13121.Peer-Reviewed Original ResearchOpioid use disorderRoutine emergency careEmergency departmentCare pathwayED initiationClinical decision supportEmergency careUse disordersEmergency Department-Initiated BuprenorphineRoutine ED careComputerized clinical decision support systemsEffective treatment optionClinical decision toolClinical decision support systemED careTreatment optionsBuprenorphineResident physiciansDirect activationCarePatientsDisordersCritical decision pointsInitial observationsPathway