title: Implementation of a clinical decision support system using a service model: results of a feasibility study.
abstract: Numerous studies have shown that the quality of health care is inadequate, and healthcare organizations are increasingly turning to clinical decision support systems (CDSS) to address this problem. In implementing CDSS, a highly promising architectural approach is the use of decision support services. However, there are few reported examples of successful implementations of operational CDSS using this approach. Here, we describe how Hospital Italiano de Buenos Aires evaluated the feasibility of using the SEBASTIAN clinical decision support Web service to implement a CDSS integrated with its electronic medical record system. The feasibility study consisted of three stages: first, end-user acceptability testing of the proposed CDSS through focus groups; second, the design and implementation of the system through integration of SEBASTIAN and the authoring of new rules; and finally, validation of system performance and accuracy. Through this study, we found that it is feasible to implement CDSS using a service-based approach. The CDSS is now under evaluation in a randomized controlled trial. The processes and lessons learned from this initiative are discussed.
authors.affiliation: Department of Health Informatics, Hospital Italiano de Buenos Aires, Argentina. damian.borbolla@hiba.org.ar
authors.forename: Damian
authors.initials: D
authors.lastname: Borbolla
authors.forename: Carlos
authors.initials: C
authors.lastname: Otero
authors.forename: David F
authors.initials: DF
authors.lastname: Lobach
authors.forename: Kensaku
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Ana M
authors.initials: AM
authors.lastname: Gomez Saldaño
authors.forename: Gustavo
authors.initials: G
authors.lastname: Staccia
authors.forename: Gastón
authors.initials: G
authors.lastname: Lopez
authors.forename: Silvana
authors.initials: S
authors.lastname: Figar
authors.forename: Daniel
authors.initials: D
authors.lastname: Luna
authors.forename: Fernan Gonzalez
authors.initials: FG
authors.lastname: Bernaldo de Quiros
mesh_terms: D020000:Decision Support Systems, Clinical; D003695:Delivery of Health Care; D057286:Electronic Health Records; D005240:Feasibility Studies; D006748:Hospital Departments; D020407:Internet