Face-to-Face: Resident-led Radiology Medicine Rounds Facilitate Evidence-based Processes for Clinical Decision Support

2020 ◽  
Author(s):  
Adam E. Goldman-Yassen ◽  
Sara B. Strauss ◽  
Peter P. Vlismas ◽  
Anand D. Jagannath ◽  
Marshall Yuan ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Evidence Based ◽  
Face To Face

Clinical Decision Support System Adoption & Implementation in African Health Systems: A SWOT Analysis. (Preprint)

2021 ◽  
Author(s):  
Victoria Oluwafunmilola Kolawole
Keyword(s):  
Developing Countries ◽  
Decision Support ◽  
Health Systems ◽  
Clinical Decision Support ◽  
Clinical Decision Support System ◽  
Swot Analysis ◽  
Clinical Decision ◽  
Developed Countries ◽  
Evidence Based ◽  
African Health

BACKGROUND The clinical decision support system (CDSS) has been an important achievement of health technology in the 21st century. In developed countries, it has transformed the way health services are being delivered and has shown to be a tool that reduces medical errors and misdiagnoses in Healthcare. However, CDSS remains underutilized in developing countries in Africa. OBJECTIVE This study aims to review the literature to improve our understanding of the “strengths, weaknesses, opportunities and threats (SWOT)” associated with CDSS implementation in African health systems. METHODS This study included a literature review conducted in PubMed with a total of 19 articles between the year 2010 to date (past 10years) reviewed for key themes and categorized into one of 4 possible areas within the SWOT analysis. RESULTS Articles reviewed showed common strengths of efficiency at the workplace, Improved healthcare quality, benefits in developed countries, good examples of evidence-based decision making. unreliable electric power supply, inconsistent Internet connectivity, clinician's limited computer skills, and lack of enough published evidence of benefits in developing countries are listed as a weakness. The opportunities are high demand for evidence-based practice in healthcare, a strong demand for quality healthcare, growing interest to use modern technologies. The common threats identified are government policy, political instability, low funding and resistance of use by providers. CONCLUSIONS There’s the need to work on the technical, organizational and financial barriers to ensure high adoption and implementation of the CDSS in African Health systems. Also, the lag on the knowledge available on its impact in developing countries must be worked on by supporting more studies to add to the body of knowledge.

scholarly journals The Use of Evidence-Based, Problem-Oriented Templates as a Clinical Decision Support in an Inpatient Electronic Health Record System

2016 ◽  
Vol 07 (03) ◽  
pp. 790-802 ◽  
Author(s):  
Nila Radhakrishnan ◽  
Carrie Warring ◽  
Ankur Jain ◽  
Jorge Fuentes ◽  
Angela Dolganiuc ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Outcome Measurement ◽  
Clinical Decision ◽  
Electronic Health Record System ◽  
Evidence Based ◽  
Health Record ◽  
Record System ◽  
Electronic Health

SummaryThe integration of clinical decision support (CDS) in documentation practices remains limited due to obstacles in provider workflows and design restrictions in electronic health records (EHRs). The use of electronic problem-oriented templates (POTs) as a CDS has been previously discussed but not widely studied.We evaluated the voluntary use of evidence-based POTs as a CDS on documentation practices.This was a randomized cohort (before and after) study of Hospitalist Attendings in an Academic Medical Center using EPIC EHRs. Primary Outcome measurement was note quality, assessed by the 9-item Physician Documentation Quality Instrument (PDQI-9). Secondary Outcome measurement was physician efficiency, assessed by the total charting time per note.Use of POTs increased the quality of note documentation [score 37.5 vs. 39.0, P = 0.0020]. The benefits of POTs scaled with use; the greatest improvement in note quality was found in notes using three or more POTs [score 40.2, P = 0.0262]. There was no significant difference in total charting time [30 minutes vs. 27 minutes, P = 0.42].Use of evidence-based and problem-oriented templates is associated with improved note quality without significant change in total charting time. It can be used as an effective CDS during note documentation. Citation: Mehta R, Radhakrishnan NS, Warring CD, Jain A, Fuentes J, Dolganiuc A, Lourdes LS, Busigin J, Leverence RR. The use of evidence-based, problemoriented templates as a clinical decision support in an inpatient electronic health record system.

scholarly journals Comparative outcome studies of clinical decision support software: limitations to the practice of evidence-based system acquisition

2015 ◽  
Vol 22 (e1) ◽  
pp. e13-e20 ◽  
Author(s):  
Gaurav Jay Dhiman ◽  
Kyle T Amber ◽  
Kenneth W. Goodman
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Conflicts Of Interest ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Sound Studies ◽  
Outcome Studies ◽  
Evidence Based ◽  
System Acquisition ◽  
Support Software

Abstract Clinical decision support systems (CDSSs) assist clinicians with patient diagnosis and treatment. However, inadequate attention has been paid to the process of selecting and buying systems. The diversity of CDSSs, coupled with research obstacles, marketplace limitations, and legal impediments, has thwarted comparative outcome studies and reduced the availability of reliable information and advice for purchasers. We review these limitations and recommend several comparative studies, which were conducted in phases; studies conducted in phases and focused on limited outcomes of safety, efficacy, and implementation in varied clinical settings. Additionally, we recommend the increased availability of guidance tools to assist purchasers with evidence-based purchases. Transparency is necessary in purchasers’ reporting of system defects and vendors’ disclosure of marketing conflicts of interest to support methodologically sound studies. Taken together, these measures can foster the evolution of evidence-based tools that, in turn, will enable and empower system purchasers to make wise choices and improve the care of patients.

scholarly journals Implementing an Electronic Clinical Decision Support Tool Into Routine Care: A Qualitative Study of Stakeholders’ Perceptions of a Post-Mastectomy Breast Reconstruction Tool

2021 ◽  
Vol 6 (2) ◽  
pp. 238146832110420
Author(s):  
Jessica Boateng ◽  
Clara N. Lee ◽  
Randi E. Foraker ◽  
Terence M. Myckatyn ◽  
Kimi Spilo ◽  
...  
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Breast Reconstruction ◽  
Shared Decision Making ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Routine Care ◽  
Evidence Based ◽  
Shared Decision ◽  
Consultation Time

Objective. To explore barriers and facilitators to implementing an evidence-based clinical decision support (CDS) tool (BREASTChoice) about post-mastectomy breast reconstruction into routine care. Materials and Methods. A stakeholder advisory group of cancer survivors, clinicians who discuss and/or perform breast reconstruction in women with cancer, and informatics professionals helped design and review the interview guide. Based on the Consolidated Framework for Implementation Research (CFIR), we conducted qualitative semistructured interviews with key stakeholders (patients, clinicians, informatics professionals) to explore intervention, setting characteristics, and process-level variables that can impact implementation. Interviews were transcribed, coded, and analyzed based on the CFIR framework using both inductive and deductive methods. Results. Fifty-seven potential participants were contacted; 49 (85.9%) were eligible, and 35 (71.4%) were enrolled, continuing until thematic saturation was reached. Participants consisted of 13 patients, 13 clinicians, and 9 informatics professionals. Stakeholders thought that BREASTChoice was useful and provided patients with an evidence-based source of information about post-mastectomy breast reconstruction, including their personalized risks. They felt that BREASTChoice could support shared decision making, improve workflow, and possibly save consultation time, but were uncertain about the best time to deliver BREASTChoice to patients. Some worried about cost, data availability, and security of integrating the tool into an electronic health record. Most acknowledged the importance of showing clinical utility to gain institutional buy-in and encourage routine adoption. Discussion and Conclusion. Stakeholders felt that BREASTChoice could support shared decision making, improve workflow, and reduce consultation time. Addressing key questions such as cost, data integration, and timing of delivering BREASTChoice could build institutional buy-in for CDS implementation. Results can guide future CDS implementation studies.

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