BMC Medical Informatics and Decision Making | |
Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study | |
Research Article | |
Blackford Middleton1  Adam Wright1  Carmit McMullen2  Richard H Dykstra3  Joan S Ash3  Arwen Bunce3  Michael Shapiro3  Kenneth P Guappone4  James Carpenter4  Dean F Sittig5  Joshua Richardson6  | |
[1] Brigham and Women's Hospital, Boston, MA, USA;Harvard Medical School, Boston, MA, USA;Partners HealthCare, Boston, MA, USA;Kaiser Permanente Center for Health Research, Portland, OR, USA;Oregon Health & Science University, Portland, OR, USA;Providence Health Systems, Portland, OR, USA;University of Texas School of Biomedical Informatics, Houston, TX, USA;Weill Cornell Medical College, New York, NY, USA; | |
关键词: Knowledge Management; Clinical Decision Support; Clinical Decision Support System; Health Information Technology; Commercial System; | |
DOI : 10.1186/1472-6947-12-6 | |
received in 2011-07-20, accepted in 2012-02-14, 发布年份 2012 | |
来源: Springer | |
【 摘 要 】
BackgroundThe 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.MethodsGuided 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.ResultsThe 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.ConclusionsThese 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.
【 授权许可】
CC BY
© Ash et al; licensee BioMed Central Ltd. 2012
【 预 览 】
Files | Size | Format | View |
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RO202311090088426ZK.pdf | 792KB | download |
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