Challenges involved in establishing a web-based clinical decision support tool in community health centers

Implementation lessons: Establishing a shared ‘hub-and-spoke,’ web-based clinical decision support system (CDSS) in an EHR shared by >600 community health centers incurred a myriad of challenges, which are summarized here to guide others seeking to use similar CDSS. Legal and compliance challenge...

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Bibliographic Details
Published in:Healthcare : the journal of delivery science and innovation 2020-12, Vol.8 (4), p.100488-100488, Article 100488
Main Authors: Gold, Rachel, Middendorf, Mary, Heintzman, John, Nelson, Joan, O'Connor, Patrick, Sperl-Hillen, JoAnn, Appana, Deepika, Geissal, Erik, Thirumalai, Vijay, Sheppler, Christina, Dunne, Maryjane
Format: Article
Language:English
Subjects:
Cardiovascular diseases
Clinical
Clinical Decision-Making - methods
Clinical practice guideline
Community Health Centers - trends
Decision support systems
Decision Support Techniques
Humans
Medical informatics
Primary care
Quality improvement
Software Design
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Summary:Implementation lessons: Establishing a shared ‘hub-and-spoke,’ web-based clinical decision support system (CDSS) in an EHR shared by >600 community health centers incurred a myriad of challenges, which are summarized here to guide others seeking to use similar CDSS. Legal and compliance challenges involved ensuring secure data exchanges, determining which entity maintains data records, and deciding which data are sent to the CDSS. Technical challenges involved using lab data from multiple sources and improving the CDSS’ cache routine performance in its new setting. Clinical implementation challenges involved identifying optimal strategies for generating data on CDSS use rates, modifying the CDSS functionality for obtaining clinician/staff feedback, and customizing the risk thresholds that trigger the CDSS for the new setting.
ISSN:2213-0764
2213-0772
DOI:10.1016/j.hjdsi.2020.100488