Recommended practices for computerized clinical decision support and knowledge management in community settings: A qualitative study

Joan S. Ash, Dean F. Sittig, Kenneth P. Guappone, Richard H. Dykstra, Joshua Richardson, Adam Wright, James Carpenter, Carmit McMullen, Michael Shapiro, Arwen Bunce, Blackford Middleton

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Background: The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods. Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results: The team identified ten themes related to CDS and KM. These include: 1) workflow; 2) knowledge management; 3) data as a foundation for CDS; 4) user computer interaction; 5) measurement and metrics; 6) governance; 7) translation for collaboration; 8) the meaning of CDS; 9) roles of special, essential people; and 10) communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions: These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors.

Original languageEnglish (US)
Article number6
JournalBMC Medical Informatics and Decision Making
Volume12
Issue number1
DOIs
StatePublished - Feb 15 2012

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ASJC Scopus subject areas

  • Health Policy
  • Health Informatics

Cite this

Ash, J. S., Sittig, D. F., Guappone, K. P., Dykstra, R. H., Richardson, J., Wright, A., Carpenter, J., McMullen, C., Shapiro, M., Bunce, A., & Middleton, B. (2012). Recommended practices for computerized clinical decision support and knowledge management in community settings: A qualitative study. BMC Medical Informatics and Decision Making, 12(1), [6]. https://doi.org/10.1186/1472-6947-12-6