| Clinical decision support capabilities of commercially-available clinical information systems. | |
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MedLine Citation:
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PMID: 19567796 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The most effective decision support systems are integrated with clinical information systems, such as inpatient and outpatient electronic health records (EHRs) and computerized provider order entry (CPOE) systems. Purpose The goal of this project was to describe and quantify the results of a study of decision support capabilities in Certification Commission for Health Information Technology (CCHIT) certified electronic health record systems. METHODS: The authors conducted a series of interviews with representatives of nine commercially available clinical information systems, evaluating their capabilities against 42 different clinical decision support features. RESULTS: Six of the nine reviewed systems offered all the applicable event-driven, action-oriented, real-time clinical decision support triggers required for initiating clinical decision support interventions. Five of the nine systems could access all the patient-specific data items identified as necessary. Six of the nine systems supported all the intervention types identified as necessary to allow clinical information systems to tailor their interventions based on the severity of the clinical situation and the user's workflow. Only one system supported all the offered choices identified as key to allowing physicians to take action directly from within the alert. Discussion The principal finding relates to system-by-system variability. The best system in our analysis had only a single missing feature (from 42 total) while the worst had eighteen.This dramatic variability in CDS capability among commercially available systems was unexpected and is a cause for concern. CONCLUSIONS: These findings have implications for four distinct constituencies: purchasers of clinical information systems, developers of clinical decision support, vendors of clinical information systems and certification bodies. |
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Authors:
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Adam Wright; Dean F Sittig; Joan S Ash; Sapna Sharma; Justine E Pang; Blackford Middleton |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. Date: 2009-06-30 |
Journal Detail:
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Title: Journal of the American Medical Informatics Association : JAMIA Volume: 16 ISSN: 1527-974X ISO Abbreviation: J Am Med Inform Assoc Publication Date: 2009 Sep-Oct |
Date Detail:
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Created Date: 2009-09-16 Completed Date: 2010-01-06 Revised Date: 2010-09-27 |
Medline Journal Info:
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Nlm Unique ID: 9430800 Medline TA: J Am Med Inform Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 637-44 Citation Subset: IM |
Affiliation:
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Partners HealthCare System, 93 Worcester St, Wellesley, MA 02481, USA. awright5@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Decision Support Systems, Clinical* Humans Software Design Technology Assessment, Biomedical United States |
| Grant Support | |
ID/Acronym/Agency:
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HHHSA 29020080010//PHS HHS; R56-LM006942-07A1/LM/NLM NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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