Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts - PubMed (original) (raw)

Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts

Kensaku Kawamoto et al. J Am Med Inform Assoc. 2013.

Abstract

Objective: To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework.

Materials and methods: As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders' viewpoints were obtained through surveys and in-depth interviews, and findings and relevant insights were summarized. Based on these insights, key principles were formulated for establishing a national CDS knowledge sharing framework.

Results: Nineteen key stakeholders were recruited, including six executives from electronic health record system vendors, seven executives from knowledge content producers, three executives from healthcare provider organizations, and three additional experts in clinical informatics. Based on these stakeholders' insights, five key principles were identified for effectively sharing CDS knowledge nationally. These principles are (1) prioritize and support the creation and maintenance of a national CDS knowledge sharing framework; (2) facilitate the development of high-value content and tooling, preferably in an open-source manner; (3) accelerate the development or licensing of required, pragmatic standards; (4) acknowledge and address medicolegal liability concerns; and (5) establish a self-sustaining business model.

Discussion: Based on the principles identified, a roadmap for national CDS knowledge sharing was developed through the ONC's Advancing CDS initiative.

Conclusion: The study findings may serve as a useful guide for ongoing activities by the ONC and others to establish a national framework for sharing CDS knowledge and improving clinical care.

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Conflict of interest statement

Competing interests: KK is a consultant to Inflexxion on a project funded by the National Institute on Drug Abuse to develop clinical decision support (CDS) capabilities for mental healthcare. KK receives royalties for a Duke University-owned CDS technology for infectious disease management known as CustomID that he helped develop. KK was formerly a consultant for Religent, Inc and a co-owner and consultant for Clinica Software, Inc, both of which provide commercial CDS services, including use of a CDS technology known as SEBASTIAN that KK developed. KK no longer has a financial relationship with either Religent or Clinica Software. The other authors have no competing interests to report.

References

    1. McDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectability of man. N Engl J Med 1976;295:1351–5 -PubMed
    1. Kawamoto K, Houlihan CA, Balas EA, et al. Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. BMJ 2005;330:765–68 -PMC -PubMed
    1. Lyman JA, Cohn WF, Bloomrosen M, et al. Clinical decision support: progress and opportunities. J Am Med Inform Assoc 2010;17:487–92 -PMC -PubMed
    1. Health Information Management Systems Society EMR Adoption Model. http://www.himssanalytics.org/emram/index.aspx (accessed May 2012).
    1. Osheroff JA, Teich JM, Middleton B, et al. A roadmap for national action on clinical decision support. J Am Med Inform Assoc 2007;14:141–5 -PMC -PubMed

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