title: Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.
abstract: Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.
authors.affiliation: Division of Clinical Informatics, Department of Community and Family Medicine, Duke University, Durham, NC, USA. david.lobach@duke.edu
authors.forename: David F
authors.initials: DF
authors.lastname: Lobach
authors.forename: Kensaku
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: Michael L
authors.initials: ML
authors.lastname: Russell
authors.forename: Peter
authors.initials: P
authors.lastname: Woods
authors.forename: Dwight
authors.initials: D
authors.lastname: Smith
mesh_terms: D001292:Attitude to Computers; D002908:Chronic Disease / Q000628:therapy*; D003199:Computer Systems; D003258:Consumer Behavior; D003625:Data Collection; D003658:Decision Making, Computer-Assisted; D020000:Decision Support Systems, Clinical / Q000592:standards* / Q000706:statistics & numerical data; D019468:Disease Management; D006801:Humans; D019095:Point-of-Care Systems