TY - JOUR
T1 - Recommended practices for computerized clinical decision support and knowledge management in community settings
T2 - A qualitative study
AU - Ash, Joan S.
AU - Sittig, Dean F.
AU - Guappone, Kenneth P.
AU - Dykstra, Richard H.
AU - Richardson, Joshua
AU - Wright, Adam
AU - Carpenter, James
AU - McMullen, Carmit
AU - Shapiro, Michael
AU - Bunce, Arwen
AU - Middleton, Blackford
N1 - Funding Information:
We are grateful to the participants who allowed us to observe and interview them during our research, and to Drs. Marc Overhage, Eric Pifer, Greg Fraser, Frank Sonnenberg, and Jason Saleem for their assistance with site visits. We thank the 17 experts who took part in our fifth Menucha conference: John Dulcey, Tom Payne, Mike Shabot, Jim Carpenter, Victor Lee, Scott Evans, Brian Patty, Eric Poon, Chuck Tucinda, Julie McGowan, Paul Nichol, Brian Churchill, Ken Guappone, Joanie Kapusnik, Dick Gibson, Gil Kuperman, and Randy Miller. This work was supported by AHRQ contract #HHSA290200810010, NLM Research Grant 563 R56-LM006942 and Training Grant 2-T15-LM007088. AHRQ and NLM had no role in the design or execution of this study, nor in the decision to publish. Finally, we would like to dedicate this paper to POET team member Richard H Dykstra, MD, MS, who was instrumental in developing the new theoretical framework but who unfortunately passed away before the paper was accepted for publication.
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
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U2 - 10.1186/1472-6947-12-6
DO - 10.1186/1472-6947-12-6
M3 - Article
C2 - 22333210
AN - SCOPUS:84857014352
SN - 1472-6947
VL - 12
JO - BMC Medical Informatics and Decision Making
JF - BMC Medical Informatics and Decision Making
IS - 1
M1 - 6
ER -