TY - JOUR
T1 - Multiple perspectives on clinical decision support
T2 - A qualitative study of fifteen clinical and vendor organizations Clinical decision-making, knowledge support systems, and theory
AU - Ash, Joan S.
AU - Sittig, Dean F.
AU - McMullen, Carmit K.
AU - Wright, Adam
AU - Bunce, Arwen
AU - Mohan, Vishnu
AU - Cohen, Deborah J.
AU - Middleton, Blackford
N1 - Funding Information:
We would like to thank all of the sites that allowed us to visit them. We also very much appreciate Jessica L. Erickson for her assistance with the manuscript. This work was supported by grant LM06942 and training grant 2T15LM007088 from the National Library of Medicine, NIH. This project is also derived from work supported under contract #HHSA290200810010 from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. Federal law, section 934(c) of the public health service act, 42 U.S.C. 299c-3 (c), protects identifiable information on which this report, presentation, or other form of disclosure is based. No identifiable information about any individuals or entities supplying the information or described in it may be knowingly used except in accordance with their prior consent. Any confidential identifiable information in this report or presentation that is knowingly disclosed is disclosed solely for the purpose for which it was provided.
Publisher Copyright:
© 2015 Ash et al.; licensee BioMed Central.
PY - 2015/4/24
Y1 - 2015/4/24
N2 - Background: Computerized clinical decision support (CDS) can help hospitals to improve healthcare. However, CDS can be problematic. The purpose of this study was to discover how the views of clinical stakeholders, CDS content vendors, and EHR vendors are alike or different with respect to challenges in the development, management, and use of CDS. Methods: We conducted ethnographic fieldwork using a Rapid Assessment Process within ten clinical and five health information technology (HIT) vendor organizations. Using an inductive analytical approach, we generated themes from the clinical, content vendor, and electronic health record vendor perspectives and compared them. Results: The groups share views on the importance of appropriate manpower, careful knowledge management, CDS that fits user workflow, the need for communication among the groups, and for mutual strategizing about the future of CDS. However, views of usability, training, metrics, interoperability, product use, and legal issues differed. Recommendations for improvement include increased collaboration to address legal, manpower, and CDS sharing issues. Conclusions: The three groups share thinking about many aspects of CDS, but views differ in a number of important respects as well. Until these three groups can reach a mutual understanding of the views of the other stakeholders, and work together, CDS will not reach its potential.
AB - Background: Computerized clinical decision support (CDS) can help hospitals to improve healthcare. However, CDS can be problematic. The purpose of this study was to discover how the views of clinical stakeholders, CDS content vendors, and EHR vendors are alike or different with respect to challenges in the development, management, and use of CDS. Methods: We conducted ethnographic fieldwork using a Rapid Assessment Process within ten clinical and five health information technology (HIT) vendor organizations. Using an inductive analytical approach, we generated themes from the clinical, content vendor, and electronic health record vendor perspectives and compared them. Results: The groups share views on the importance of appropriate manpower, careful knowledge management, CDS that fits user workflow, the need for communication among the groups, and for mutual strategizing about the future of CDS. However, views of usability, training, metrics, interoperability, product use, and legal issues differed. Recommendations for improvement include increased collaboration to address legal, manpower, and CDS sharing issues. Conclusions: The three groups share thinking about many aspects of CDS, but views differ in a number of important respects as well. Until these three groups can reach a mutual understanding of the views of the other stakeholders, and work together, CDS will not reach its potential.
KW - Clinical decision support
KW - Governance
KW - Knowledge management
KW - Rapid assessment process
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U2 - 10.1186/s12911-015-0156-4
DO - 10.1186/s12911-015-0156-4
M3 - Article
C2 - 25903564
AN - SCOPUS:84934875329
SN - 1472-6947
VL - 15
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 35
ER -