Adaptation of a Published Risk Model to Point-of-care Clinical Decision Support Tailored to Local Workflow.

Electronic clinical decision support can bring newly published knowledge to the point of care. However, local organizational buy-in, support for team workflows, IT system ease of use and other sociotechnical factors are needed to promote adoption. We successfully implemented a multi-variate cardiac risk stratification model from another institution into ours. We recreated the model and integrated it into our workflow, accessing it from our EHR with patient-specific data and facilitating clinical documentation if the user accepts the model results. Our clinical leaders championed the change and led educational dissemination efforts. We describe the ad-hoc social and technical collaboration needed to build and deploy the tool. The tool complements a clinical initiative within a community of practice, and is correlated with appropriate use of nuclear imaging.