Browsing by Subject "computerized clinical decision support"

Now showing 1 - 3 of 3
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    Development of a Workflow Integration Survey (WIS) for Implementing Computerized Clinical Decision Support
    (2011-10) Flanagan, Mindy; Arbuckle, Nicole; Saleem, Jason J.; Militello, Laura G.; Haggstrom, David A.; Doebbeling, Bradley N.
    Interventions that focus on improving computerized clinical decision support (CDS) demonstrate that successful workflow integration can increase the adoption and use of CDS. However, metrics for assessing workflow integration in clinical settings are not well established. The goal of this study was to develop and validate a survey to assess the extent to which CDS is integrated into workflow. Qualitative data on CDS design, usability, and integration from four sites was collected by direct observation, interviews, and focus groups. Thematic analysis based on the sociotechnical systems theory revealed consistent themes across sites. Themes related to workflow integration included navigation, functionality, usability, and workload. Based on these themes, a brief 12-item scale to assess workflow integration was developed, refined, and validated with providers in a simulation study. To our knowledge, this is one of the first tools developed to specifically measure workflow integration of CDS.
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    Medical legal partnership and health informatics impacting child health: Interprofessional innovations
    (Taylor and Francis, 2015-06) Gilbert, Amy Lewis; Downs, Stephen M.; Department of Pediatrics, IU School of Medicine
    Dramatic differences in health are closely related to degrees of social and economic disadvantage. Poverty-induced hardships such as food insecurity, utility shut-offs, and substandard housing, all have the potential to negatively impact the health of families. In an effort to better address social determinants of health in pediatric primary health care settings using the Medical Legal Partnership (MLP) model of health care delivery, an interprofessional team of investigators came together to design an innovative process for using computerized clinical decision support to identify health-harming legal and social needs, improve the delivery of appropriate physician counseling, and streamline access to legal and social service professionals when non-medical remedies are required. This article describes the interprofessional nature of the MLP model itself, illustrates the work that was done to craft this innovative health informatics approach to implementing MLP, and demonstrates how pediatricians, social workers and attorneys may work together to improve child health outcomes.
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    Provider Perceptions of Colorectal Cancer Screening Clinical Decision Support at Three Benchmark Institutions
    (2009-11) Saleem, Jason J.; Militello, Laura G.; Arbuckle, Nicole; Flanagan, Mindy; Haggstrom, David A.; Linder, Jeffrey A.; Doebbeling, Bradley N.
    Implementation of computerized clinical decision support (CDS), and its integration into workflow has not reached its potential. To better understand the use of CDS for colorectal cancer (CRC) screening at benchmark institutions for health information technology (HIT), we conducted direct observation, including opportunistic interviews of primary care providers, as well as key informant interviews and focus groups, to document current challenges to CRC screening and follow-up at clinics affiliated with the Veterans Heath Administration, Regenstrief Institute, and Partners HealthCare System. Analysis revealed six common barriers across institutions from the primary care providers’ perspective: receiving and documenting “outside” exam results, inaccuracy of the CDS, compliance issues, poor usability, lack of coordination between primary care and gastroenterology, and the need to attend to more urgent patient issues. Strategies should be developed to enhance current HIT to address these challenges and better support primary care providers and staff.