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

Joan 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

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Decision support
Knowledge management
Qualitative study
Physicians
Veterans
Information systems
Financial incentives
Health care quality

ASJC Scopus subject areas

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

Cite this

Ash, J., Sittig, D. F., Guappone, K. P., Dykstra, R. H., Richardson, J., Wright, 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

Recommended practices for computerized clinical decision support and knowledge management in community settings : A qualitative study. / Ash, Joan; Sittig, Dean F.; Guappone, Kenneth P.; Dykstra, Richard H.; Richardson, Joshua; Wright, Adam; Carpenter, James; McMullen, Carmit; Shapiro, Michael; Bunce, Arwen; Middleton, Blackford.

Electronic Health Records: Challenges in Design and Implementation. Apple Academic Press, 2013. p. 163-202.

Research output: Chapter in Book/Report/Conference proceedingChapter

Ash, J, Sittig, DF, Guappone, KP, Dykstra, RH, 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. Apple Academic Press, pp. 163-202. https://doi.org/10.1201/b16306
Ash J, Sittig DF, Guappone KP, Dykstra RH, Richardson J, Wright A et al. 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. Apple Academic Press. 2013. p. 163-202 https://doi.org/10.1201/b16306
Ash, Joan ; Sittig, Dean F. ; Guappone, Kenneth P. ; Dykstra, Richard H. ; Richardson, Joshua ; Wright, Adam ; Carpenter, James ; McMullen, Carmit ; Shapiro, Michael ; Bunce, Arwen ; Middleton, Blackford. / Recommended practices for computerized clinical decision support and knowledge management in community settings : A qualitative study. Electronic Health Records: Challenges in Design and Implementation. Apple Academic Press, 2013. pp. 163-202
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