Clinical Decision Support: What is it? Why is it so hard? What can we do about it?

Date: March 02, 2011 Time: (All day)
Event Type: Lecture

Clinical decision support (CDS), 'providing clinicians or patients with clinical knowledge and patient-specific information, intelligently filtered and presented at appropriate times, to enhance patient care', is key to achieving our national goals for improvement in healthcare quality and safety, while reducing its costs. We have been working to understand the barriers and facilitators to implementing CDS within healthcare organizations. We have developed a Rapid Assessment Process, a mixed-method evaluation approach adapted from anthropology, to study clinicians, administrators, and information technologists as they worked to design, develop, and implement these systems. We have identified the following ten themes related to CDS, including: 1) workflow, 2) knowledge management, 3) data as a foundation for CDS, 4) user computer interaction; 5) measurement and monitoring, 6) governance, 7) translation for collaboration, 8) the meaning of CDS, 9) new roles for special people, and 10) communication, training, and support. To be successful, an organization must carefully navigate each of these areas. These themes also have implications for future research and development, workforce training, and national policy implications.

Dean F. Sittig, PhD is a professor at the University of Texas, School of Biomedical Informatics in Houston, TX. He is interested in all aspects of clinical information system design, development, implementation, and evaluation. In addition to his work on measuring the impact of clinical information systems on a large scale, he is working to improve our understanding of both the factors that lead to success, as well as, the unintended consequences associated with computer-based clinical decision support and provider order entry systems. In addition to over 200 scientific publications, he has co-authored several award-winning books on clinical decision support including: 'Improving Outcomes - A Practical Guide to Clinical Decision Support Implementation', 'Improving Medication Use and Outcomes with Clinical Decision Support A Step-by-Step Guide' and more recently, 'Clinical Information Systems: Overcoming Adverse Consequences'.