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. 2014 May-Jun;21(3):464-72.
doi: 10.1136/amiajnl-2013-001771. Epub 2013 Sep 2.

A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success

Adam Wright  1 , Joan S Ash, Jessica L Erickson, Joe Wasserman, Arwen Bunce, Ana Stanescu, Daniel St Hilaire, Morgan Panzenhagen, Eric Gebhardt, Carmit McMullen, Blackford Middleton, Dean F Sittig
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A qualitative study of the activities performed by people involved in clinical decision support: recommended practices for success

Adam Wright et al. J Am Med Inform Assoc. 2014 May-Jun.

Abstract

Objective: To describe the activities performed by people involved in clinical decision support (CDS) at leading sites.

Materials and methods: We conducted ethnographic observations at seven diverse sites with a history of excellence in CDS using the Rapid Assessment Process and analyzed the data using a series of card sorts, informed by Linstone's Multiple Perspectives Model.

Results: We identified 18 activities and grouped them into four areas. Area 1: Fostering relationships across the organization, with activities (a) training and support, (b) visibility/presence on the floor, (c) liaising between people, (d) administration and leadership, (e) project management, (f) cheerleading/buy-in/sponsorship, (g) preparing for CDS implementation. Area 2: Assembling the system with activities (a) providing technical support, (b) CDS content development, (c) purchasing products from vendors (d) knowledge management, (e) system integration. Area 3: Using CDS to achieve the organization's goals with activities (a) reporting, (b) requirements-gathering/specifications, (c) monitoring CDS, (d) linking CDS to goals, (e) managing data. Area 4: Participation in external policy and standards activities (this area consists of only a single activity). We also identified a set of recommendations associated with these 18 activities.

Discussion: All 18 activities we identified were performed at all sites, although the way they were organized into roles differed substantially. We consider these activities critical to the success of a CDS program.

Conclusions: A series of activities are performed by sites strong in CDS, and sites adopting CDS should ensure they incorporate these activities into their efforts.

Keywords: clinical decision support; governance; implementation; knowledge management; rapid assessment process.

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Figures

Figure 1
Figure 1
Multiple Perspectives Model. Figure from Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study. BMC medical informatics and decision-making, and republished here with permission of the author.18
See this image and copyright information in PMC

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