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: Chapter in Book/Report/Conference proceedingChapter

Abstract

There is substantial evidence that computerized provider order entry (CPOE) with clinical decision support (CDS) can enhance health care quality and efficiency [1-5]. We define CDS broadly to include "passive and active referential information as well as computer-based order sets, reminders, alerts, and condition or patient-specific data displays that are accessible at the point of care [[6], p. 524]." Interest in CPOE with CDS is intensifying among clinicians and hospitals in the U.S. as federally funded financial incentives are enacted [7]. At present, only 10 to 20 percent of hospitals have CPOE [8,9], the large majority of which are academic hospitals with teaching programs or hospitals with large numbers of employed physicians, such as Veterans Affairs or Kaiser Permanente hospitals [9]. Although 86% of the 5815 hospitals in the U.S. are community hospitals [10], only 6.9% of them report having even a basic CPOE system [9]. In ambulatory settings, 17% of physicians report that they use clinical information systems, and only 4% of those physicians use systems that include CPOE and CDS [11]. The numbers, however, are rapidly rising.

Original languageEnglish (US)
Title of host publicationElectronic Health Records
Subtitle of host publicationChallenges in Design and Implementation
PublisherApple Academic Press
Pages163-202
Number of pages40
ISBN (Electronic)9781482231557
ISBN (Print)9781926895932
DOIs
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Economics, Econometrics and Finance(all)
  • Business, Management and Accounting(all)

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    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. (2013). Recommended practices for computerized clinical decision support and knowledge management in community settings: A qualitative study. In Electronic Health Records: Challenges in Design and Implementation (pp. 163-202). Apple Academic Press. https://doi.org/10.1201/b16306