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
Adam Wright
1  Brigham & Women’s Hospital, Boston, MA, USA
2  Partners HealthCare, Boston, MA, USA
3  Harvard Medical School, Boston, MA, USA
,
Shobha Phansalkar
1  Brigham & Women’s Hospital, Boston, MA, USA
2  Partners HealthCare, Boston, MA, USA
3  Harvard Medical School, Boston, MA, USA
,
Meryl Bloomrosen
4  American Medical Informatics Association, Bethesda, MD, USA
,
Robert A. Jenders
5  Cedars-Sinai Medical Center, Los Angeles, CA
6  University of California Los Angeles, Los Angeles, CA, USA
,
Anne M. Bobb
7  Northwestern Memorial Hospital, Chicago, IL, USA
,
John D. Halamka
3  Harvard Medical School, Boston, MA, USA
8  CareGroup Healthcare System, Boston, MA, USA
,
Gilad Kuperman
9  New York Presbyterian Hospital, New York, NY, USA
10  Weill Cornell Medical College, New York, USA
,
Thomas H. Payne
11  University of Washington, Seattle, WA, USA
,
S. Teasdale
12  American Medical Association, Chicago, IL, USA (retired)
,
A. J. Vaida
13  Institute for Safe Medication Practices, Horsham, PA, USA
,
D. W. Bates
1  Brigham & Women’s Hospital, Boston, MA, USA
2  Partners HealthCare, Boston, MA, USA
3  Harvard Medical School, Boston, MA, USA
› Author Affiliations
Further Information

Correspondence to:

Adam Wright, Ph.D.
Brigham and Women’s Hospital
1620 Tremont St.
Boston, MA 02115

Publication History

received: 17 May 2010

accepted: 16 August 2010

Publication Date:
16 December 2017 (online)

 

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.


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Conflicts of interest

None of the authors has a conflict of interest to declare with respect to the content of this manuscript.


Correspondence to:

Adam Wright, Ph.D.
Brigham and Women’s Hospital
1620 Tremont St.
Boston, MA 02115