Evidence map›Paper›PMID 16290243›Full record

ArticleJournal of biomedical informatics2005

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

Randolph A Miller, Lemuel R Waitman, Sutin Chen, S Trent Rosenbloom

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of biomedical informatics, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. The impact of computerized provider order entry systems on medical-imaging services: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2011
    Pooled it
  4. Computerized clinical decision support for prescribing: provision does not guarantee uptake.Journal of the American Medical Informatics Association : JAMIA
    Pooled it
  5. Pooled it
  6. Trial
  7. Impact of non-interruptive medication laboratory monitoring alerts in ambulatory care.Journal of the American Medical Informatics Association : JAMIA
    Trial
  8. Randomized trial to improve prescribing safety during pregnancy.Journal of the American Medical Informatics Association : JAMIA
    Trial
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  16. SIGNALING SEPSIS SCENARIO DEVELOPMENT & VALIDATION.Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting. Human Factors and Ergonomics Society. Annual meeting · 2018
    Article
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  19. Review
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Randolph A MillerDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37232-8340, USA. Randolph.A.Miller@vanderbilt.edu
Lemuel R Waitman
Sutin Chen
S Trent Rosenbloom

Funding

TIME:(Tools for Inpatient Monitoring using Evidence)for Safe &AppropriateTestingR01LM007995 · NLM · VANDERBILT UNIVERSITY · PI MILLER, RANDOLPH A · 2004 to 2009
$2.1M
Testing Evaluation Metrics for Interface TerminologiesK22LM008576 · NLM · VANDERBILT UNIVERSITY · PI ROSENBLOOM, SAMUEL T · 2005 to 2007
$453k
PATIENT CARE PROVIDER ORDER ENTRY WITH TACTICAL SUPPORTR01LM006226 · NLM · VANDERBILT UNIVERSITY · PI MILLER, RANDOLPH A · 1997 to 1999
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NLM NIH HHS K22 LM008576NLM NIH HHS K22-LM-08576NLM NIH HHS R01 LM007995NLM NIH HHS R01-LM-007995NLM NIH HHS R01-LM-06226
6 · The paper itself

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.

Indexed as

InpatientsAdmitting Department, HospitalDecision Making, OrganizationalHumansPatient Education as TopicPersonnel, HospitalProfessional-Patient RelationsTennessee

Identifiers

PMID16290243
PMCPMC1518541

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.