@article{d0b808423f954bddb898b61610ebce63,
title = "Challenges involved in establishing a web-based clinical decision support tool in community health centers",
abstract = "Implementation lessons: Establishing a shared {\textquoteleft}hub-and-spoke,{\textquoteright} 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{\textquoteright} 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.",
keywords = "Cardiovascular diseases, Clinical, Clinical practice guideline, Decision support systems, Medical informatics, Primary care, Quality improvement",
author = "Rachel Gold and Mary Middendorf and John Heintzman and Joan Nelson and Patrick O'Connor and Sperl-Hillen, {Jo Ann} and Deepika Appana and Erik Geissal and Vijay Thirumalai and Christina Sheppler and Maryjane Dunne",
note = "Funding Information: Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL133793. During the study period, Drs. O'Connor and Sperl-Hillen were also partially supported by National Institute of Health Award Number P30DK092924. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL133793 . During the study period, Drs. O'Connor and Sperl-Hillen were also partially supported by National Institute of Health Award Number P30DK092924 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2020",
year = "2020",
month = dec,
doi = "10.1016/j.hjdsi.2020.100488",
language = "English (US)",
volume = "8",
journal = "Healthcare",
issn = "2213-0764",
publisher = "Elsevier BV",
number = "4",
}