Cited by 144Electronic Health Records SystemsArtificial Intelligence in Healthcare and EducationTechnology and Human Factors in Education and Health

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The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

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Miller, Randolph A., Waitman, Lemuel R., Chen, Sutin, Rosenbloom, S. Trent·2005·Journal of Biomedical Informatics

DOI 10.1016/j.jbi.2005.08.009

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Abstract

The authors describe a pragmatic approach to the introduction of clinical decision support at the point of care, based on a decade of experience in developing and evolving Vanderbilt's inpatient "WizOrder" care provider order entry (CPOE) system. The inpatient care setting provides a unique opportunity to interject CPOE-based decision support features that restructure clinical workflows, deliver focused relevant educational materials, and influence how care is delivered to patients. From their empirical observations, the authors have developed a generic model for decision support within inpatient CPOE systems. They believe that the model's utility extends beyond Vanderbilt, because it is based on characteristics of end-user workflows and on decision support considerations that are common to a variety of inpatient settings and CPOE systems. The specific approach to implementing a given clinical decision support feature within a CPOE system should involve evaluation along three axes: what type of intervention to create (for which the authors describe 4 general categories); when to introduce the intervention into the user's workflow (for which the authors present 7 categories), and how disruptive, during use of the system, the intervention might be to end-users' workflows (for which the authors describe 6 categories). Framing decision support in this manner may help both developers and clinical end-users plan future alterations to their systems when needs for new decision support features arise.

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Authors: Miller, R. A., Waitman, L. R., Chen, S., & Rosenbloom, S. T.
Affiliations: Vanderbilt University Medical Center (US)
Corresponding author: Miller, Randolph A.
ORCID: Waitman, Lemuel R.
Rosenbloom, S. Trent
Venue: Journal of Biomedical Informatics
Publisher: Elsevier BV
Published: 2005-12
Volume: 38
Issue: 6
Pages: 469-485
ISSN: 1532-0464 (ISSN-L)
DOI: 10.1016/j.jbi.2005.08.009
OpenAlex: W2098595796
Cited by: 144
References: 102
Citations by year: 2024: 5 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 5 · 2017: 8 · 2016: 11 · 2015: 7 · 2014: 7 · 2013: 13 · 2012: 11
FWCI: 18.87
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 2785 d)
Locations: Journal of Biomedical Informatics (publishedVersion)
PubMed (publishedVersion)
Funders: Vanderbilt University
National Institutes of Health (5r01lm007995-06, 5r01lm006226-03)
School of Medicine, Vanderbilt University
U.S. National Library of Medicine (K22-LM-08576, R01-LM-007995, K22LM008576, LM06226, R01-LM-06226)
Topics: Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Technology and Human Factors in Education and Health
Keywords: clinical decision support, computerized physician order entry, inpatient care, point-of-care intervention, clinical workflow, workflow disruption, clinical teaching
MeSH terms: Admitting Department, Hospital, Decision Making, Organizational, Humans, Inpatients, Patient Education as Topic, Personnel, Hospital, Professional-Patient Relations, Tennessee

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The anatomy of decision support during inpatient care provider order entry (CPOE): Empirical observations from a decade of CPOE experience at Vanderbilt

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