Standard practices for computerized clinical decision support in community hospitals: a national survey
Open accessAbstract
OBJECTIVE: Computerized provider order entry (CPOE) with clinical decision support (CDS) can help hospitals improve care. Little is known about what CDS is presently in use and how it is managed, however, especially in community hospitals. This study sought to address this knowledge gap by identifying standard practices related to CDS in US community hospitals with mature CPOE systems. MATERIALS AND METHODS: Representatives of 34 community hospitals, each of which had over 5 years experience with CPOE, were interviewed to identify standard practices related to CDS. Data were analyzed with a mix of descriptive statistics and qualitative approaches to the identification of patterns, themes and trends. RESULTS: This broad sample of community hospitals had robust levels of CDS despite their small size and the independent nature of many of their physician staff members. The hospitals uniformly used medication alerts and order sets, had sophisticated governance procedures for CDS, and employed staff to customize CDS. DISCUSSION: The level of customization needed for most CDS before implementation was greater than expected. Customization requires skilled individuals who represent an emerging manpower need at this type of hospital. CONCLUSION: These results bode well for robust diffusion of CDS to similar hospitals in the process of adopting CDS and suggest that national policies to promote CDS use may be successful.
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A key challenge with clinical decision support is knowledge management as guidelines and best practices change over time, as well as governance.
“A key challenge with clinical decision support is knowledge management as guidelines and best practices change over time,40–42 as well as governance.43–45”
From Clinician collaboration to improve clinical decision support: the Clickbusters initiative (2022) · cites this paper as [45]
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Clinician collaboration to improve clinical decision support: the Clickbusters initiative
McCoy, A. B., Russo, E. M., Johnson, K. B., Addison, B., Patel, N., Wanderer, J. P., Mize, D. E., Jackson, J. G., Reese, T. J., Littlejohn, S., et al. (2022) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocac027 · Cited by 41 · see citing works
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- Authors
- Ash, J. S., McCormack, J. L., Sittig, D. F., Wright, A., McMullen, C., & Bates, D. W.
- Affiliations
- Oregon Health & Science University (US)
- Brigham and Women's Hospital (US)
- Kaiser Permanente Center for Health Research (US)
- Corresponding author
- Ash, Joan S
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-11
- Volume
- 19
- Issue
- 6
- Pages
- 980-987
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC3486730
- OpenAlex
- W2164031526
- Cited by
- 41
- References
- 2
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 3 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 6 · 2013: 7 · 2012: 1
- FWCI
- 8.43
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- other-oa
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- National Institutes of Health
- U.S. Public Health Service (ASMMI0031)
- U.S. National Library of Medicine (R01LM006942, LM06942, R56LM006942)
- 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, community hospitals, medication alerts, order sets, hospital staff roles, health information technology adoption
- MeSH terms
- Diffusion of Innovation, Health Plan Implementation, Hospitals, Community, Humans, United States, Health Care Surveys, Decision Support Systems, Clinical, Medical Order Entry Systems
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