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Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack

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Towards a Maturity Model for Clinical Decision Support Operations.

Evan W Orenstein^1,2, Naveen Muthu^3,4, Asli O Weitkamp⁵

¹Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States.

Applied Clinical Informatics

|November 1, 2019

Summary

Managing clinical decision support (CDS) systems is challenging. This study introduces a maturity model to help healthcare organizations optimize CDS operations and improve patient outcomes through structured development.

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Area of Science:

Health Informatics
Clinical Decision Support Systems
Healthcare Quality Improvement

Background:

Clinical decision support (CDS) systems integrated with electronic health records are crucial for healthcare quality and safety.
Managing extensive CDS knowledge bases and aligning informatics teams with operational stakeholders presents significant challenges.
Effective CDS utilization is vital for driving better patient outcomes.

Purpose of the Study:

To develop a comprehensive maturity model for clinical decision support (CDS) operations.
To provide a roadmap for healthcare systems to enhance CDS effectiveness and achieve better outcomes.
To guide informatics teams in managing CDS knowledge bases and communicating improvement goals.

Main Methods:

Discussions with healthcare leaders from 80 organizations.
Iterative model development by four clinical informaticists.
Review and feedback from 19 healthcare organizations to finalize the model.

Main Results:

A proposed CDS maturity model with three pillars: Content Creation, Analytics and Reporting, and Governance and Management.
Each pillar comprises five progressive levels, guiding teams toward deeper process understanding.
A 'roof' element signifies advanced CDS functions achievable through pillar progression.

Conclusions:

The maturity model offers a structured approach for healthcare organizations to enhance CDS operations.
Advancing through the model's pillars, particularly in tandem, is hypothesized to maximize the value of CDS investments.
Case studies demonstrate the model's utility for self-assessment and strategic planning in CDS development.