A lifecycle framework illustrates eight stages necessary for realizing the benefits of patient-centered clinical decision support

J Am Med Inform Assoc. 2023 Aug 18;30(9):1583-1589. doi: 10.1093/jamia/ocad122.


The design, development, implementation, use, and evaluation of high-quality, patient-centered clinical decision support (PC CDS) is necessary if we are to achieve the quintuple aim in healthcare. We developed a PC CDS lifecycle framework to promote a common understanding and language for communication among researchers, patients, clinicians, and policymakers. The framework puts the patient, and/or their caregiver at the center and illustrates how they are involved in all the following stages: Computable Clinical Knowledge, Patient-specific Inference, Information Delivery, Clinical Decision, Patient Behaviors, Health Outcomes, Aggregate Data, and patient-centered outcomes research (PCOR) Evidence. Using this idealized framework reminds key stakeholders that developing, deploying, and evaluating PC-CDS is a complex, sociotechnical challenge that requires consideration of all 8 stages. In addition, we need to ensure that patients, their caregivers, and the clinicians caring for them are explicitly involved at each stage to help us achieve the quintuple aim.

Keywords: clinical decision support; medical informatics applications; patient-centered care; shared decision making.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Communication
  • Decision Support Systems, Clinical*
  • Delivery of Health Care
  • Humans
  • Patient-Centered Care
  • Patients