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Recommended practices for computerized clinical decision support and knowledge management in community settings: a
Joan S Ash1, Dean F Sittig, Kenneth P Guappone
1Oregon Health & Science University, Portland, OR, USA. ash@ohsu.edu
BMC Medical Informatics and Decision Making
|February 16, 2012
Summary
Recommended practices for clinical decision support (CDS) and knowledge management (KM) were identified across U.S. ambulatory clinics and hospitals. Ten key themes emerged, guiding successful implementation and informing future informatics research.
Area of Science:
- Health Informatics
- Clinical Decision Support Systems
- Knowledge Management
Background:
- Focus on computerized clinical decision support (CDS) and knowledge management (KM) in U.S. ambulatory clinics and community hospitals.
- Examines both commercial and locally developed systems.
Purpose of the Study:
- Identify recommended practices for CDS development and implementation.
- Identify recommended practices for knowledge management (KM) processes.
Main Methods:
- Ethnographic field studies utilizing the Multiple Perspectives Framework.
- Employed Rapid Assessment Process including interviews, observations, and surveys.
- Data analysis involved template and grounded methods; expert panel developed recommendations.
Main Results:
- Identified ten key themes: workflow, KM, data foundation, user computer interaction, metrics, governance, translation, CDS meaning, roles, and communication/training/support.
- Modified Multiple Perspectives framework to include Translational Interaction construct.
- Experts developed recommendations for each identified theme.
Conclusions:
- Ten themes are crucial for successful CDS implementation in clinics and hospitals.
- Findings have implications for workforce education, research, and national policy.
- Translational Interaction construct offers a guide for future applied informatics research.
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