Best Practices in Clinical Decision Support

Adam Wright; Shobha Phansalkar; Meryl Bloomrosen; Robert A. Jenders; Anne M. Bobb; John D. Halamka; Gilad Kuperman; Thomas H. Payne; S. Teasdale; A. J. Vaida; D. W. Bates

doi:10.4338/ACI-2010-05-RA-0031

Applied Clinical Informatics, Inhaltsverzeichnis

Appl Clin Inform 2010; 01(03): 331-345
DOI: 10.4338/ACI-2010-05-RA-0031

Research Article

Schattauer GmbH

Best Practices in Clinical Decision Support

The Case of Preventive Care Reminders

Authors

Adam Wright

¹Brigham & Women’s Hospital, Boston, MA, USA

²Partners HealthCare, Boston, MA, USA

³Harvard Medical School, Boston, MA, USA
Shobha Phansalkar

¹Brigham & Women’s Hospital, Boston, MA, USA

²Partners HealthCare, Boston, MA, USA

³Harvard Medical School, Boston, MA, USA
Meryl Bloomrosen

⁴American Medical Informatics Association, Bethesda, MD, USA
Robert A. Jenders

⁵Cedars-Sinai Medical Center, Los Angeles, CA

⁶University of California Los Angeles, Los Angeles, CA, USA
Anne M. Bobb

⁷Northwestern Memorial Hospital, Chicago, IL, USA
John D. Halamka

³Harvard Medical School, Boston, MA, USA

⁸CareGroup Healthcare System, Boston, MA, USA
Gilad Kuperman

⁹New York Presbyterian Hospital, New York, NY, USA

¹⁰Weill Cornell Medical College, New York, USA
Thomas H. Payne

¹¹University of Washington, Seattle, WA, USA
S. Teasdale

¹²American Medical Association, Chicago, IL, USA (retired)
A. J. Vaida

¹³Institute for Safe Medication Practices, Horsham, PA, USA
D. W. Bates

¹Brigham & Women’s Hospital, Boston, MA, USA

²Partners HealthCare, Boston, MA, USA

³Harvard Medical School, Boston, MA, USA

Abstract

Summary

Background: Evidence demonstrates that clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety. However, implementing and maintaining effective decision support interventions presents multiple technical and organizational challenges.

Purpose: To identify best practices for CDS, using the domain of preventive care reminders as an example.

Methods: We assembled a panel of experts in CDS and held a series of facilitated online and in-person discussions. We analyzed the results of these discussions using a grounded theory method to elicit themes and best practices.

Results: Eight best practice themes were identified as important: deliver CDS in the most appropriate ways, develop effective governance structures, consider use of incentives, be aware of workflow, keep content current, monitor and evaluate impact, maintain high quality data, and consider sharing content. Keys themes within each of these areas were also described.

Conclusion: Successful implementation of CDS requires consideration of both technical and socio-technical factors. The themes identified in this study provide guidance on crucial factors that need consideration when CDS is implemented across healthcare settings. These best practice themes may be useful for developers, implementers, and users of decision support.

Keywords

Clinical decision support systems - clinical governance - computerized medical record systems - hospital information systems

Volltext

Referenzen

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