title: Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality.
abstract: While evidence-based medicine has increasingly broad-based support in health care, it remains difficult to get physicians to actually practice it. Across most domains in medicine, practice has lagged behind knowledge by at least several years. The authors believe that the key tools for closing this gap will be information systems that provide decision support to users at the time they make decisions, which should result in improved quality of care. Furthermore, providers make many errors, and clinical decision support can be useful for finding and preventing such errors. Over the last eight years the authors have implemented and studied the impact of decision support across a broad array of domains and have found a number of common elements important to success. The goal of this report is to discuss these lessons learned in the interest of informing the efforts of others working to make the practice of evidence-based medicine a reality.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. dbates@partners.org
authors.forename: David W
authors.initials: DW
authors.lastname: Bates
authors.forename: Gilad J
authors.initials: GJ
authors.lastname: Kuperman
authors.forename: Samuel
authors.initials: S
authors.lastname: Wang
authors.forename: Tejal
authors.initials: T
authors.lastname: Gandhi
authors.forename: Anne
authors.initials: A
authors.lastname: Kittler
authors.forename: Lynn
authors.initials: L
authors.lastname: Volk
authors.forename: Cynthia
authors.initials: C
authors.lastname: Spurr
authors.forename: Ramin
authors.initials: R
authors.lastname: Khorasani
authors.forename: Milenko
authors.initials: M
authors.lastname: Tanasijevic
authors.forename: Blackford
authors.initials: B
authors.lastname: Middleton
mesh_terms: D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D006801:Humans; D014584:User-Computer Interface