Multiple perspectives on clinical decision support: A qualitative study of fifteen clinical and vendor organizations Clinical decision-making, knowledge support systems, and theory

Joan S. Ash, Dean F. Sittig, Carmit K. McMullen, Adam Wright, Arwen Bunce, Vishnu Mohan, Deborah J. Cohen, Blackford Middleton

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Computerized clinical decision support (CDS) can help hospitals to improve healthcare. However, CDS can be problematic. The purpose of this study was to discover how the views of clinical stakeholders, CDS content vendors, and EHR vendors are alike or different with respect to challenges in the development, management, and use of CDS. Methods: We conducted ethnographic fieldwork using a Rapid Assessment Process within ten clinical and five health information technology (HIT) vendor organizations. Using an inductive analytical approach, we generated themes from the clinical, content vendor, and electronic health record vendor perspectives and compared them. Results: The groups share views on the importance of appropriate manpower, careful knowledge management, CDS that fits user workflow, the need for communication among the groups, and for mutual strategizing about the future of CDS. However, views of usability, training, metrics, interoperability, product use, and legal issues differed. Recommendations for improvement include increased collaboration to address legal, manpower, and CDS sharing issues. Conclusions: The three groups share thinking about many aspects of CDS, but views differ in a number of important respects as well. Until these three groups can reach a mutual understanding of the views of the other stakeholders, and work together, CDS will not reach its potential.

Original languageEnglish (US)
Article number35
JournalBMC Medical Informatics and Decision Making
Volume15
Issue number1
DOIs
StatePublished - Apr 24 2015

Keywords

  • Clinical decision support
  • Governance
  • Knowledge management
  • Rapid assessment process

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics

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