An integrated approach to computer-based decision support at the point of care

Information needs that arise when clinicians use clinical information systems often go unresolved, forcing clinicians to defer decisions or make them with incomplete knowledge. My research characterizes these needs in order to build information systems that can help clinicians get timely answers to their questions. My colleagues and I have developed "Infobuttons", which are links between clinical information systems and on-line knowledge resources, and have developed an "Infobutton Manager" (IM) that attempts to determine the information need based on the context of what the user is doing. The IM presents users with a set of questions, each of which is a link to an online information resource that will answer the question. The Infobutton Manager has been successfully deployed in five systems at four institutions and provides users with over 1,000 accesses to on-line health information each month, with a positive impact on patient care.