Introduction: Urinary incontinence (UI) care is becoming increasingly important in primary care. Women’s Preventative Services Initiative has recommended annual UI screening; however, screening cannot be effective if primary care providers (PCPs) are not equipped to manage positive screens. Our pilot data for a multi-site randomized cluster study showed that patients receive only 40% of recommended UI care from PCPs, illustrating a need for tools to support PCPs in managing this condition. Clinical decision support (CDS) systems provide relevant and targeted information to clinicians at the time of clinical decision-making. We aimed to develop CDS tools for the evaluation and management of UI in primary care. Methods: A team of clinical informaticists at 4 Southern California sites was assembled to build the CDS. Our team met with primary care leaders to discuss PCP utilization of electronic medical record features to determine which tools would be most effectively incorporated into existing provider workflows. UI specialists were consulted on relevant clinical information to include in the CDS. The final CDS components included note templates, order sets, and best practice advisory alerts. These tools presented information on aspects of a detailed history, diagnostic criteria for stress and urge UI, relevant portions of a physical exam, and first-line therapy options including behavioral modifications, pelvic floor physical therapy, and medications. Results: A set of evidence-based quality indicators for UI care was used to objectively evaluate the CDS. The tools addressed all 13 quality measures. In the pilot study at a single site, PCPs utilized the CDS, followed treatment algorithms, and reduced their referrals to specialists. The CDS build was adapted to 4 Southern California academic institutions and is scheduled to be implemented in October-November 2022. Conclusions: PCPs will be faced with the challenge of providing quality UI care as annual screening is implemented. We describe a process for developing a set of CDS tools for the evaluation and management UI that can be adopted by healthcare systems seeking to empower PCPs to independently initiate management and improve quality of care of this burdensome condition. SOURCE OF Funding: This study was funded by the Agency for Healthcare Research and Quality. Project number: 1U18HS028740
.jpg "Isabella Dolendo, BS (she/her/hers) photo")
