Clinical Decision Support to Prevent Suicide

"Experimental: CDS Intervention Adult patients in the highest predicted risk tier (\>=2% predicted risk) at the time visit registration (aka check-in).~The Intervention would then be described as:~Physicians review a Best Practice Advisory describing the patient's risk and choose from the following options:~1. Document face-to-face suicide risk screening with the Columbia Suicide Severity Rating Scale (CDS complete once the CSSRS is complete)~2. Agree to screen using an alternative method chosen at the clinician's discretion (CDS complete)~3. Disagree with alert and provide a rationale for disagreement (CDS complete)~4. Indicate suicide risk face-to-face screening has already occurred (CDS complete)~5. Dismiss the alert. The alert will be available in Epic Storyboard persistently until acted on further. The Storyboard functionality after dismissal is identical to the Passive Prompt, CDS intervention (below)"

"Adult patients in the highest predicted risk tier (\>=2% predicted risk, based on our research study, DOI: 10.1001/jamanetworkopen.2021.1428) at the time of visit registration (aka check-in) will be randomized to either the Interruptive Alert or Passive Prompt CDS intervention arms.~In the Passive Prompt arm, the physician who next opens the patients' charts after check-in (e.g., Chart Review) will see a Storyboard icon for Elevated Suicide Risk on the left side of the screen. Hovering over this icon will bring up a window with the BPA information in a view identical to the Interruptive Alert arm. Clicking on the window will bring up the BPA with full functionality as in the Interruptive Alert arm."