Lessons learned from implementing service-oriented clinical decision support at four sites: A qualitative study

International Journal of Medical Informatics

Volumn 84, Issue 11, 2015, Pages 901-911

  Wright, Adam ^a,b,c   Sittig, Dean F ^d   Ash, Joan S ^e   Erickson, Jessica L ^a,c   Hickman, Trang T ^a,c   Paterno, Marilyn ^a,b,c   Gebhardt, Eric ^e   McMullen, Carmit ^f   Tsurikova, Ruslana ^a,c   Dixon, Brian E ^g,h,i   Fraser, Greg ^j   Simonaitis, Linas ^g,i   Sonnenberg, Frank A ^k   Middleton, Blackford ^l  

^a BRIGHAM AND WOMEN S HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c PARTNERS HEALTHCARE   (United States)

^d UNIVERSITY OF TEXAS   (United States)

^e OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

^f CENTER FOR HEALTH RESEARCH   (United States)

^g REGENSTRIEF INSTITUTE   (United States)

^h INDIANA UNIVERSITY   (United States)

ⁱ VETERANS AFFAIRS MEDICAL CENTER   (United States)

^j WVP Health Authority   (United States)

^k ROBERT WOOD JOHNSON MEDICAL SCHOOL   (United States)

^l VANDERBILT UNIVERSITY   (United States)

more..

Author keywords

Clinical decision support systems; Computerized; Distributed systems; Electronic health records; Medical record systems; Service oriented architecture

Indexed keywords

ARTIFICIAL INTELLIGENCE; COMPUTER HARDWARE; DISTRIBUTED COMPUTER SYSTEMS; HEALTH; HUMAN COMPUTER INTERACTION; INFORMATION SERVICES; LAWS AND LEGISLATION; RECORDS MANAGEMENT; SERVICE ORIENTED ARCHITECTURE (SOA); TERMINOLOGY;

CLINICAL DECISION SUPPORT SYSTEMS; COMPUTERIZED; DISTRIBUTED SYSTEMS; ELECTRONIC HEALTH RECORD; MEDICAL RECORD SYSTEMS;

DECISION SUPPORT SYSTEMS;

ARTICLE; CLINICAL OBSERVATION; COMPUTER; COMPUTER INTERFACE; COMPUTER PROGRAM; DATA ANALYSIS; DECISION SUPPORT SYSTEM; ETHNOGRAPHIC RESEARCH; INFORMATION PROCESSING; INFORMATION RETRIEVAL; INTERPERSONAL COMMUNICATION; INTERVIEW; PRESSURE; PRIORITY JOURNAL; QUALITATIVE RESEARCH; REGULATORY MECHANISM; WORKFLOW; CLINICAL DECISION SUPPORT SYSTEM; COMPUTER SYSTEM; CULTURAL ANTHROPOLOGY; ELECTRONIC HEALTH RECORD; HUMAN; ORGANIZATION AND MANAGEMENT; PATIENT SAFETY; PUBLIC RELATIONS; STANDARDS; UNITED STATES;

ANTHROPOLOGY, CULTURAL; COMPUTER SYSTEMS; DECISION SUPPORT SYSTEMS, CLINICAL; ELECTRONIC HEALTH RECORDS; HUMANS; INTERPROFESSIONAL RELATIONS; INTERVIEWS AS TOPIC; PATIENT SAFETY; QUALITATIVE RESEARCH; UNITED STATES; USER-COMPUTER INTERFACE; WORKFLOW;

EID: 84942551476     PISSN: 13865056     EISSN: 18728243     Source Type: Journal    
DOI: 10.1016/j.ijmedinf.2015.08.008     Document Type: Article

References (42)

1. McDonald C.J. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N. Engl. J. Med. 1976, 295(December (24)):1351-1355.
2. Druss B.G., Marcus S.C. Growth and decentralization of the medical literature: implications for evidence-based medicine. JMLA 2005, 93(October (4)):499-501.
3. Chaudhry B., Wang J., Wu S., et al. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann. Intern. Med. 2006, 144(May (10)):742-752.
4. Garg A.X., Adhikari N.K., McDonald H., et al. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review. JAMA 2005, 293(March (10)):1223-1238.
5. Kawamoto K., Houlihan C.A., Balas E.A., Lobach D.F. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ (Clin. Res. Ed.) 2005, 330(April (7494)):765-770.
6. Lobach D., Sanders G.D., Bright T.J., et al. Enabling health care decisionmaking through clinical decision support and knowledge management. Evid. Rep. 2012, (April (203)):1-784.
7. Roshanov P.S., Misra S., Gerstein H.C., et al. Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review. Implement Sci. 2011, 6:92.
8. Sim I., Gorman P., Greenes R.A., et al. Clinical decision support systems for the practice of evidence-based medicine. JAMIA 2001, 8(November-December (6)):527-534.
9. Blumenthal D., Tavenner M. The meaningful use regulation for electronic health records. N. Engl. J. Med. 2010, 363(August (6)):501-504.
10. Centers for Medicare and Medicaid Services. Stage 2 Eligible Professional (EP) Meaningful Use Core and Menu Measures. 2012 [cited 2014 4 Aug]; . http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage2_MeaningfulUseSpecSheet_TableContents_EPs.pdf.
11. Sittig D.F., Wright A., Osheroff J.A., et al. Grand challenges in clinical decision support. J. Biomed. Inform. 2008, 41(April (2)):387-392.
12. Wright A., Sittig D.F. A four-phase model of the evolution of clinical decision support architectures. Int. J. Med. Inf. 2008, 77(October (10)):641-649.
13. Kawamoto K., Lobach D.F. Proposal for fulfilling strategic objectives of the U.S. Roadmap for national action on clinical decision support through a service-oriented architecture leveraging HL7 services. JAMIA 2007, 14(March-April (2)):146-155.
14. Osheroff J.A., Teich J.M., Middleton B., Steen E.B., Wright A., Detmer D.E. A roadmap for national action on clinical decision support. JAMIA 2007, 14(March-April (2)):141-145.
15. Lyman J.A., Cohn W.F., Bloomrosen M., Detmer D.E. Clinical decision support: progress and opportunities. J. Am. Med. Inform. Assoc. 2010, 17(5):487-492.
16. Shiffman R.N., Agrawal A., Deshpande A.M., Gershkovich P. An approach to guideline implementation with GEM. Stud. Health Technol. Inf. 2001, 84(Pt. (1)):271-275.
17. Feblowitz J.C., Wright A., Singh H., Samal L., Sittig D.F. Summarization of clinical information: a conceptual model. J. Biomed. Inf. 2011, 44(August (4)):688-699.
18. Middleton B., Anderson J., Fletcher J., Masarie F.E., Leavitt M.K. Use of the WWW for distributed knowledge engineering for an EMR: the KnowledgeBank concept. Proceedings/AMIA Annual Symposium AMIA Symposium 1998, 126-130.
19. OpenClinical. Summaries of guideline representation methods. [cited 2013 Jan]; . http://www.openclinical.org/gmmsummaries.html.
20. Hripcsak G. Arden syntax for medical logic modules. MD Comput. 1991, 8(March-April (2)):76-78.
21. Ohno-Machado L., Gennari J.H., Murphy S.N., et al. The guideline interchange format: a model for representing guidelines. JAMIA 1998, 5(July-August (4)):357-372.
22. Choi J., Lussier Y.A., Mendoca E.A. Adapting current Arden Syntax knowledge for an object oriented event monitor. AMIA Annual Symposium Proceedings/AMIA Symposium AMIA Symposium 2003, 814.
23. Middleton B. The clinical decision support consortium. Stud. Health Technol. Inf. 2009, 150:26-30.
24. Wright A., Sittig D.F. SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network. J. Biomed. Inf. 2008 Dec, 41(6):962-981.
25. Nadkarni P.M., Miller R.A. Service-oriented architecture in medical software: promises and perils. JAMIA 2007, 14(March-April (2)):244-246.
26. Goldberg H.S., Paterno M.D., Rocha B.H., et al. A highly scalable, interoperable clinical decision support service. JAMIA 2014, 21(February (e1)):e55-e62.
27. D'Amore J.D., Sittig D.F., Wright A., Iyengar M.S., Ness R.B. The promise of the CCD: challenges and opportunity for quality improvement and population health. AMIA Ann. Symp. Proc. 2011, 2011:285-294.
28. HITSP. C32: Summary Documents Using HL7Continuity of Care Document (CCD) Component. 2009 [cited 2014 30 July]; . http://www.hitsp.org/ConstructSet_Details.aspx%3F&PrefixAlpha=4&PrefixNumeric=32.
29. Boxwala A.A., Rocha B.H., Maviglia S., et al. A multi-layered framework for disseminating knowledge for computer-based decision support. JAMIA 2011, 18(December (Suppl. 1)):i132-i139.
30. Paterno M.D., Goldberg H.S., Simonaitis L., et al. Using a service oriented architecture approach to clinical decision support: performance results from two CDS Consortium demonstrations. AMIA Ann. Symp. Proc. 2012, 2012:690-698.
31. Ash J.S., Sittig D.F., Dykstra R., et al. Identifying best practices for clinical decision support and knowledge management in the field. Stud. Health Technol. Inf. 2010, 160(Pt. (2)):806-810.
32. McMullen C.K., Ash J.S., Sittig D.F., et al. Rapid assessment of clinical information systems in the healthcare setting: an efficient method for time-pressed evaluation. Methods Inf. Med. 2011, 50(4):299-307.
33. Ash J.S., Sittig D.F., Guappone K.P., et al. Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study. BMC Med. Inf. Decis. Mak. 2012, 12:6.
34. Wright A., Ash J.S., Erickson J.L., et al. A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success. JAMIA 2014, 21(May-June (3)):464-472.
35. Dixon B.E., Simonaitis L., Goldberg H.S., et al. A pilot study of distributed knowledge management and clinical decision support in the cloud. Artif. Intell. Med. 2013, 59(Sep (1)):45-53.
36. Dixon B.E., Simonaitis L., Perkins S.M., Wright A., Middleton B. Measuring agreement between decision support reminders: the cloud vs. the local expert. BMC Med. Inf. Decis. Mak. 2014, 14:31.
37. Ash J.S., Sittig D.F., Wright A., et al. Clinical decision support in small community practice settings: a case study. JAMIA 2011, 18(November-December (6)):879-882.
38. Sittig D.F., Singh H. A new sociotechnical model for studying health information technology in complex adaptive healthcare systems. Qual. Saf. Health Care 2010, 19(October (Suppl. 3)):i68-74.
39. D'Amore J.D., Mandel J.C., Kreda D.A., et al. Are meaningful use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative. J. Am. Med. Inform. Assoc. 2014, 21(Nov-Dec (6)):1060-1068.
40. Dixon B.E., Simonaitis L., Goldberg H.S., et al. A pilot study of distributed knowledge management and clinical decision support in the cloud. Artif. Intell. Med. 2013, 59(September (1)):45-53.
41. Hongsermeier T., Maviglia S., Tsurikova L., et al. A legal framework to enable sharing of clinical decision support knowledge and services across institutional boundaries. AMIA Annu. Symp. Proc. 2011, 2011:925-933.
42. Wright A., Goldberg H., Hongsermeier T., Middleton B. A description and functional taxonomy of rule-based decision support content at a large integrated delivery network. JAMIA 2007, 14(July-August (4)):489-496.