title: Examining the relationship between clinical decision support and performance measurement.
abstract: In concept and practice, clinical decision support (CDS) and performance measurement represent distinct approaches to organizational change, yet these two organizational processes are interrelated. We set out to better understand how the relationship between the two is perceived, as well as how they jointly influence clinical practice. To understand the use of CDS at benchmark institutions, we conducted semistructured interviews with key managers, information technology personnel, and clinical leaders during a qualitative field study. Improved performance was frequently cited as a rationale for the use of clinical reminders. Pay-for-performance efforts also appeared to provide motivation for the use of clinical reminders. Shared performance measures were associated with shared clinical reminders. The close link between clinical reminders and performance measurement causes these tools to have many of the same implementation challenges.
authors.affiliation: VA HSR&D Center on Implementing Evidence-Based Practice, Roudebush VAMC, Indianapolis, IN, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Haggstrom
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Saleem
authors.forename: Laura G
authors.initials: LG
authors.lastname: Militello
authors.forename: Nicole
authors.initials: N
authors.lastname: Arbuckle
authors.forename: Mindy
authors.initials: M
authors.lastname: Flanagan
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D020000:Decision Support Systems, Clinical; D004650:Employee Performance Appraisal; D007407:Interviews as Topic; D017064:Process Assessment, Health Care; D017010:Reminder Systems; D014481:United States