Related Experiment Video
Updated: May 12, 2026
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
A pilot study of distributed knowledge management and clinical decision support in the cloud
Brian E Dixon1, Linas Simonaitis, Howard S Goldberg
1School of Informatics and Computing, Indiana University-Purdue University Indianapolis, 535 W. Michigan Street, Indianapolis, IN 46202, USA; Center for Biomedical Informatics, Regenstrief Institute, 410 W. 10th Street, Suite 2000, Indianapolis, IN 46202, USA; Center of Excellence on Implementing Evidence-Based Practice, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service, 1481 W. 10th Street, 11H, Indianapolis, IN 46202, USA.
Cloud-based clinical decision support (CDS) is feasible, with pilot testing showing successful data exchange and reminder generation. Key challenges for adoption include governance, interoperability, and usability, requiring interdisciplinary collaboration.
Area of Science:
- Biomedical Informatics
- Health IT
Background:
- Web-based clinical decision support (CDS) services can improve patient care.
- Developing and managing clinical knowledge in a distributed, cloud-based manner presents unique challenges.
- Previous frameworks for CDS have limitations in scalability and interoperability.
Purpose of the Study:
- To pilot test a novel framework for cloud-based CDS services.
- To assess the connectivity and data/knowledge exchange with an external CDS service.
- To identify lessons learned for future expansion of cloud-based CDS.
Main Methods:
- A CDS knowledge repository was established in a community cloud.
- Limited patient data was securely transmitted to a cloud-hosted CDS rules engine.
- Preventive care reminders were generated and displayed to clinicians.
Main Results:
- 1339 patient encounters successfully exchanged information during a six-month pilot.
- Preventive care reminders were displayed in 57% of visits.
- Reminders frequently addressed hypertension and diabetes management.
Conclusions:
- Remote, cloud-based CDS performed well but faces challenges in governance, semantic interoperability, and usability.
- Successful adoption requires collaboration between biomedical informatics and computer science.
- Cloud-based CDS is a feasible approach to enhance clinical decision-making support for a broad range of providers.
Related Concept Videos
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:20Integrated Healthcare System
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...