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Lessons Learned from a National Initiative Promoting Publicly Available Standards-Based Clinical Decision Support.

Rina V Dhopeshwarkar1, Maysoun Freij2, Melissa Callaham1

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Publicly available, standards-based clinical decision support (CDS) offers potential but faces implementation challenges. Building trust through transparency and support for resource-limited health systems is crucial for widespread adoption of these evidence-based tools.

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Area of Science:

  • Health Informatics
  • Clinical Decision Support Systems
  • Evidence-Based Practice

Background:

  • Clinical decision support (CDS) tools enhance patient care and reduce errors by aiding clinical decision-making.
  • Standards-based CDS promotes interoperability and reduces redundant development efforts across healthcare institutions.
  • Publicly available, standards-based CDS is an emerging area with significant but underexplored potential.

Purpose of the Study:

  • To identify lessons learned from a national initiative focused on publicly available, standards-based CDS resources.
  • To discuss challenges encountered in the development and dissemination of these resources.
  • To propose recommendations for improving the implementation and adoption of standards-based CDS.

Main Methods:

  • Evaluation of the Agency for Healthcare Research and Quality Patient-Centered Outcomes Research CDS Initiative.
  • Review of literature and program materials.
  • Key informant interviews and a web-based survey on a public CDS repository and authoring tools.

Main Results:

  • Trust is paramount for CDS adoption, enhanced by transparency, expert collaboration, and user feedback loops.
  • Wider adoption of EHR standards will facilitate CDS implementation, but lower-resourced systems require additional support.
  • Health systems need more data on patient-centered, clinical, and cost outcomes to justify investment in publicly available CDS.

Conclusions:

  • Standards and technology for sharing CDS have advanced, but broad implementation and dissemination remain significant hurdles.
  • Addressing trust, resource disparities, and outcome justification is essential for realizing the full potential of standards-based CDS.