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Using clinical decision support as a means of implementing a universal postpartum depression screening program

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Abstract

A major barrier to the diagnosis of postpartum depression (PPD) includes symptom detection. The lack of awareness and understanding of PPD among new mothers, the variability in clinical presentation, and the various diagnostic strategies can increase this further. The purpose of this study was to test the feasibility of adding clinical decision support (CDS) to the electronic health record (EHR) as a means of implementing a universal standardized PPD screening program within a large, at high risk, population. All women returning to the Mount Sinai Hospital OB/GYN Ambulatory Practice for postpartum care between 2010 and 2013 were presented with the Edinburgh Postnatal Depression Scale (EPDS) in response to a CDS “hard stop” built into the EHR. Of the 2102 women who presented for postpartum care, 2092 women (99.5 %) were screened for PPD in response to a CDS hard stop module. Screens were missing on ten records (0.5 %) secondary to refusal, language barrier, or lack of clarity in the EHR. Technology is becoming increasingly important in addressing the challenges faced by health care providers. While the identification of PPD has become the recent focus of public health concerns secondary to the significant social burden, numerous barriers to screening still exist within the clinical setting. The utility of adding CDS in the form of a hard stop, requiring clinicians to enter a standardized PPD mood assessment score to the patient EHR, offers a sufficient way to address a primary barrier to PPD symptom identification at the practitioner level.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Science, Icahn Medical School at Mount Sinai Hospital, New York, NY, USA

    Holly Loudon & Farida Nentin

  2. Department of Psychiatry, Icahn Medical School at Mount Sinai Hospital, New York, NY, USA

    Michael E. Silverman

Authors
  1. Holly Loudon
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  2. Farida Nentin
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  3. Michael E. Silverman
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Correspondence to Michael E. Silverman.

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The authors declare that they have no conflict of interest to report.

Because this is a retrospective study involving de-identified chart information, formal consent is not required. This article does not contain any studies with human participants or animals performed by any of the authors

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Loudon, H., Nentin, F. & Silverman, M.E. Using clinical decision support as a means of implementing a universal postpartum depression screening program. Arch Womens Ment Health 19, 501–505 (2016). https://doi.org/10.1007/s00737-015-0596-y

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  • DOI: https://doi.org/10.1007/s00737-015-0596-y

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