Journal
HEALTHCARE-THE JOURNAL OF DELIVERY SCIENCE AND INNOVATION
Volume 8, Issue 4, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.hjdsi.2020.100488
Keywords
Medical informatics; Decision support systems; Clinical; Clinical practice guideline; Cardiovascular diseases; Primary care; Quality improvement
Funding
- National Heart, Lung, And Blood Institute of the National Institutes of Health [R01HL133793]
- National Institute of Health [P30DK092924]
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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.
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