Evidence map›Paper›PMID 25903564›Full record

ArticleBMC medical informatics and decision making2015

Multiple perspectives on clinical decision support: a qualitative study of fifteen clinical and vendor organizations.

Joan S Ash, Dean F Sittig, Carmit K McMullen, Adam Wright, Arwen Bunce, Vishnu Mohan, Deborah J Cohen, Blackford Middleton

Abstract read
In one paragraph

Article in BMC medical informatics and decision making, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 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

15 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
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  8. Review
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  12. Clinical decision support alert malfunctions: analysis and empirically derived taxonomy.Journal of the American Medical Informatics Association : JAMIA · 2018
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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

8 authors.

Joan S AshOregon Health & Science University, Portland, OR, USA. ash@ohsu.edu.
Dean F SittigUniversity of Texas School of Biomedical Informatics, Houston, TX, USA.
Carmit K McMullenKaiser Permanente Center for Health Research, Portland, OR, USA.
Adam WrightBrigham and Women's Hospital, Boston, MA, USA.
Arwen BunceKaiser Permanente Center for Health Research, Portland, OR, USA.
Vishnu MohanOregon Health & Science University, Portland, OR, USA.
Deborah J CohenOregon Health & Science University, Portland, OR, USA.
Blackford MiddletonVanderbilt University, Nashville, TN, USA.

Funding

TRAINING PROGRAM IN HEALTH INFORMATICST15LM007088 · NLM · OREGON HEALTH & SCIENCE UNIVERSITY · PI WILLIAM R HERSH, Vishnu Mohan · 1992 to 2026
$23.4M
Unintended Consequences of Physician Order EntryR01LM006942 · NLM · OREGON HEALTH & SCIENCE UNIVERSITY · PI ASH, JOAN S. · 2000 to 2010
$4.0M
Clinical Decision Support in Community Hospitals: Barriers & FacilitatorsR56LM006942 · NLM · OREGON HEALTH & SCIENCE UNIVERSITY · PI ASH, JOAN S. · 2007 to 2007
$461k
NLM NIH HHS 2T15LM007088NLM NIH HHS LM06942NLM NIH HHS R01 LM006942NLM NIH HHS R56 LM006942NLM NIH HHS T15 LM007088PHS HHS HHSA290200810010
6 · The paper itself

Abstract

backgroundComputerized clinical decision support (CDS) can help hospitals to improve healthcare. However, CDS can be problematic. The purpose of this study was to discover how the views of clinical stakeholders, CDS content vendors, and EHR vendors are alike or different with respect to challenges in the development, management, and use of CDS.

methodsWe conducted ethnographic fieldwork using a Rapid Assessment Process within ten clinical and five health information technology (HIT) vendor organizations. Using an inductive analytical approach, we generated themes from the clinical, content vendor, and electronic health record vendor perspectives and compared them.

resultsThe groups share views on the importance of appropriate manpower, careful knowledge management, CDS that fits user workflow, the need for communication among the groups, and for mutual strategizing about the future of CDS. However, views of usability, training, metrics, interoperability, product use, and legal issues differed. Recommendations for improvement include increased collaboration to address legal, manpower, and CDS sharing issues.

conclusionsThe three groups share thinking about many aspects of CDS, but views differ in a number of important respects as well. Until these three groups can reach a mutual understanding of the views of the other stakeholders, and work together, CDS will not reach its potential.

Indexed as

AdultDecision Support Systems, ClinicalElectronic Health RecordsHumansKnowledge ManagementQualitative Research

Identifiers

PMID25903564
PMCPMC4447027

What OpenQuestion holds

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LicenceCC BY
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.