Evidence map›Paper›PMID 34142016›Full record

ArticleJAMIA open2021

A thematic analysis to examine the feasibility of EHR-based clinical decision support for implementing

Brian J Douthit, Catherine J Staes, Guilherme Del Fiol, Rachel L Richesson

Abstract read
In one paragraph

Article in JAMIA open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Interruptive Electronic Alerts for Choosing Wisely Recommendations: A Cluster Randomized Controlled Trial.Journal of the American Medical Informatics Association : JAMIA · 2022
    Trial
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.

Brian J DouthitSchool of Nursing, Duke University, Durham, North Carolina, USA.ORCID https://orcid.org/0000-0001-6634-8171
Catherine J StaesDepartment of Learning Health Sciences, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Guilherme Del FiolDepartment of Biomedical Informatics, University of Utah, Salt Lake City, Utah, USA.
Rachel L RichessonUniversity of Michigan Medical School, Ann Arbor, Michigan, USA.

Funding

Quantifying System and Data Readiness for Automated Clinical Decision SupportR15LM012335 · NLM · DUKE UNIVERSITY · PI RICHESSON, RACHEL L · 2016 to 2016
$408k
NLM NIH HHS R15 LM012335
6 · The paper itself

Abstract

objectiveTo identify important barriers and facilitators relating to the feasibility of implementing clinical practice guidelines (CPGs) as clinical decision support (CDS). MATERIALS AND

methodsWe conducted a qualitative, thematic analysis of interviews from seven interviews with dyads (one clinical expert and one systems analyst) who discussed the feasibility of implementing 10 Choosing Wisely

resultsWe identified five themes: concern about data quality impacts implementation planning; the availability of data in a computable format is a primary factor for implementation feasibility; customized strategies are needed to mitigate uncertainty and ambiguity when translating CPGs to an electronic health record-based tool; misalignment of expected CDS with pre-existing clinical workflows impact implementation; and individual level factors of end-users must be considered when selecting and implementing CDS tools. DISCUSSION: The themes reveal several considerations for CPG as CDS implementations regarding data quality, knowledge representation, and sociotechnical issues. Guideline authors should be aware that using CDS to implement CPGs is becoming increasingly popular and should consider providing clear guidelines to aid implementation. The complex nature of CPG as CDS implementation necessitates a unified effort to overcome these challenges.

conclusionOur analysis highlights the importance of cooperation and co-development of standards, strategies, and infrastructure to address the difficulties of implementing CPGs as CDS. The complex interactions between the concepts revealed in the interviews necessitates the need that such work should not be conducted in silos. We also implore that implementers disseminate their experiences.

Indexed as

clinical decision supportelectronic health recordimplementation sciencepractice guidelines as topicqualitative research

Identifiers

PMID34142016
PMCPMC8206400

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.