Verifiable Indicators

Means of verification

Critical assumptions

Goal

Decrease harm associated with over-screening of PSA testing

Decreased rate of prostate biopsies

EMR data

Patients agree with the risk/benefit analysis that recommends against PSA screening in all populations regardless of evidence based practices

Outcome

Decrease rate of PSA screening in men with low and moderate life expectancy

Rate of PSA testing

EMR data

Over-screening in vulnerable populations leads to greater risk of side effects from unnecessary testing and procedures without a substantial increase in benefit derived.

Output

All JHCP providers use the education and CDSS tools to inform decision making re: screening

Provider compliance with CDSS recommendations

Chart review of randomly selected patients across all 10 JHCP sites

Individual patient characteristics unaccounted for in the CDSS development process do not unduly impact provider compliance with the recommendations for testing.

Input

• Develop curriculum for shared decision making and PSA screening for providers
• Develop CDSS to guide providers through the screening decision making process
• Pilot test the CDSS with “super users” and a select focus group of patients
• Expand implementation

• Completion of web-based training modules by providers
• Quarterly meetings of “super users”

• Monitor completion rates of modules by individual providers
• Review attendance of quarterly meetings (observation)

• Providers are amenable to changing their practice
• Implementation of the CDSS does not add significant time or administrative burden to the primary care encounter