Literature DB >> 33132174

Challenges involved in establishing a web-based clinical decision support tool in community health centers.

Rachel Gold1, Mary Middendorf2, John Heintzman2, Joan Nelson2, Patrick O'Connor3, JoAnn Sperl-Hillen3, Deepika Appana3, Erik Geissal2, Vijay Thirumalai3, Christina Sheppler4, Maryjane Dunne2.   

Abstract

Implementation lessons: Establishing a shared 'hub-and-spoke,' web-based clinical decision support system (CDSS) in an EHR shared by >600 community health centers incurred a myriad of challenges, which are summarized here to guide others seeking to use similar CDSS. Legal and compliance challenges involved ensuring secure data exchanges, determining which entity maintains data records, and deciding which data are sent to the CDSS. Technical challenges involved using lab data from multiple sources and improving the CDSS' cache routine performance in its new setting. Clinical implementation challenges involved identifying optimal strategies for generating data on CDSS use rates, modifying the CDSS functionality for obtaining clinician/staff feedback, and customizing the risk thresholds that trigger the CDSS for the new setting.
Copyright © 2020 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Cardiovascular diseases; Clinical; Clinical practice guideline; Decision support systems; Medical informatics; Primary care; Quality improvement

Mesh：

Year:  2020        PMID： 33132174      PMCID： PMC7680381          DOI： 10.1016/j.hjdsi.2020.100488

Source DB:  PubMed          Journal:  Healthc (Amst)        ISSN： 2213-0764


  28 in total

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Journal:  JAMA       Date:  2005-08-10       Impact factor: 56.272

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Journal:  Circulation       Date:  2013-11-12       Impact factor: 29.690

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Journal:  Circulation       Date:  2013-11-12       Impact factor: 29.690

Review 4.  Effectiveness of computerized decision support systems linked to electronic health records: a systematic review and meta-analysis.

Authors:  Lorenzo Moja; Koren H Kwag; Theodore Lytras; Lorenzo Bertizzolo; Linn Brandt; Valentina Pecoraro; Giulio Rigon; Alberto Vaona; Francesca Ruggiero; Massimo Mangia; Alfonso Iorio; Ilkka Kunnamo; Stefanos Bonovas
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Journal:  Arch Pathol Lab Med       Date:  2019-06-20       Impact factor: 5.534

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Journal:  J Am Med Inform Assoc       Date:  2014-06-09       Impact factor: 4.497

Review 8.  Can computerized clinical decision support systems improve practitioners' diagnostic test ordering behavior? A decision-maker-researcher partnership systematic review.

Authors:  Pavel S Roshanov; John J You; Jasmine Dhaliwal; David Koff; Jean A Mackay; Lorraine Weise-Kelly; Tamara Navarro; Nancy L Wilczynski; R Brian Haynes
Journal:  Implement Sci       Date:  2011-08-03       Impact factor: 7.327

Review 9.  Clinical decision support: effectiveness in improving quality processes and clinical outcomes and factors that may influence success.

Authors:  Elizabeth V Murphy
Journal:  Yale J Biol Med       Date:  2014-06-06

10.  Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system.

Authors:  Jessica S Ancker; Alison Edwards; Sarah Nosal; Diane Hauser; Elizabeth Mauer; Rainu Kaushal
Journal:  BMC Med Inform Decis Mak       Date:  2017-04-10       Impact factor: 2.796
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  1 in total

1.  Effect of Clinical Decision Support at Community Health Centers on the Risk of Cardiovascular Disease: A Cluster Randomized Clinical Trial.

Authors:  Rachel Gold; Annie E Larson; JoAnn M Sperl-Hillen; David Boston; Christina R Sheppler; John Heintzman; Carmit McMullen; Mary Middendorf; Deepika Appana; Vijayakumar Thirumalai; Ann Romer; Julianne Bava; James V Davis; Nadia Yosuf; Jenny Hauschildt; Kristin Scott; Susan Moore; Patrick J O'Connor
Journal:  JAMA Netw Open       Date:  2022-02-01
  1 in total

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