title: Designing CIS to improve decisions in depression disease management: a discourse analysis of front line practice.
abstract: Clinical care management promises to help diminish the major health problem of depression. To realize this promise, front line clinicians must know which care management interventions are best for which patients and act accordingly. Unfortunately, the detailed intervention data required for such differentiated assessments are missing in most clinical information systems (CIS). To determine frontline clinicians' needs for these data and to identify the data that CIS should keep, we conducted an 18 month ethnographic study and discourse analysis of telehealth depression care management. Results show care managers need data-based evidence to choose best options, and discourse analysis suggests some personalized interventions that CIS should and can feasibly capture for evidence.
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Mirel
authors.forename: Mark S
authors.initials: MS
authors.lastname: Ackerman
authors.forename: Kevin
authors.initials: K
authors.lastname: Kerber
authors.forename: Michael
authors.initials: M
authors.lastname: Klinkman
mesh_terms: D000046:Academic Medical Centers; D020000:Decision Support Systems, Clinical; D003866:Depressive Disorder / Q000628:therapy*; D019468:Disease Management; D006751:Hospital Information Systems; D006801:Humans; D016347:Medical Records Systems, Computerized; D008605:Mental Health Services; D010044:Outpatient Clinics, Hospital; D010346:Patient Care Management / Q000379:methods*; D017216:Telemedicine