Challenges involved in establishing a web-based clinical decision support tool in community health centers

Rachel Gold, Mary Middendorf, John Heintzman, Joan Nelson, Patrick O'Connor, Jo Ann Sperl-Hillen, Deepika Appana, Erik Geissal, Vijay Thirumalai, Christina Sheppler, Maryjane Dunne

Research output: Contribution to journalArticlepeer-review

Abstract

Implementation lessons: Establishing a shared ‘hub-and-spoke,’ web-based clinical decision support system (CDSS) in an EHR shared by >600 community health centers incurred a myriad of challenges, which are summarized here to guide others seeking to use similar CDSS. Legal and compliance challenges involved ensuring secure data exchanges, determining which entity maintains data records, and deciding which data are sent to the CDSS. Technical challenges involved using lab data from multiple sources and improving the CDSS’ cache routine performance in its new setting. Clinical implementation challenges involved identifying optimal strategies for generating data on CDSS use rates, modifying the CDSS functionality for obtaining clinician/staff feedback, and customizing the risk thresholds that trigger the CDSS for the new setting.

Original languageEnglish (US)
Article number100488
JournalHealthcare
Volume8
Issue number4
DOIs
StatePublished - Dec 2020
Externally publishedYes

Keywords

  • Cardiovascular diseases
  • Clinical
  • Clinical practice guideline
  • Decision support systems
  • Medical informatics
  • Primary care
  • Quality improvement

ASJC Scopus subject areas

  • Health Policy

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