Challenges involved in establishing a web-based clinical decision support tool in community health centers.
Cardiovascular diseases
Clinical
Clinical practice guideline
Decision support systems
Medical informatics
Primary care
Quality improvement
Journal
Healthcare (Amsterdam, Netherlands)
ISSN: 2213-0772
Titre abrégé: Healthc (Amst)
Pays: Netherlands
ID NLM: 101622189
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
16
04
2020
revised:
08
10
2020
accepted:
16
10
2020
pubmed:
3
11
2020
medline:
30
6
2021
entrez:
2
11
2020
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33132174
pii: S2213-0764(20)30087-7
doi: 10.1016/j.hjdsi.2020.100488
pmc: PMC7680381
mid: NIHMS1642819
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
100488Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL133793
Pays : United States
Organisme : NHLBI NIH HHS
ID : R18 HL095481
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30 DK092924
Pays : United States
Organisme : NIDDK NIH HHS
ID : R18 DK114701
Pays : United States
Organisme : NIDDK NIH HHS
ID : R18 DK105463
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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