title: Identifying best practices for clinical decision support and knowledge management in the field.
abstract: To investigate best practices for implementing and managing clinical decision support (CDS) in community hospitals and ambulatory settings, we carried out a series of ethnographic studies to gather information from nine diverse organizations. Using the Rapid Assessment Process methodology, we conducted surveys, interviews, and observations over a period of two years in eight different geographic regions of the U.S.A. We first utilized a template organizing method for an expedited analysis of the data, followed by a deeper and more time consuming interpretive approach. We identified five major categories of best practices that require careful consideration while carrying out the planning, implementation, and knowledge management processes related to CDS. As more health care organizations implement clinical systems such as computerized provider order entry with CDS, descriptions of lessons learned by CDS pioneers can provide valuable guidance so that CDS can have optimal impact on health care quality.
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA. ash@ohsu.edu
authors.forename: Joan S
authors.initials: JS
authors.lastname: Ash
authors.forename: Dean F
authors.initials: DF
authors.lastname: Sittig
authors.forename: Richard
authors.initials: R
authors.lastname: Dykstra
authors.forename: Adam
authors.initials: A
authors.lastname: Wright
authors.forename: Carmit
authors.initials: C
authors.lastname: McMullen
authors.forename: Joshua
authors.initials: J
authors.lastname: Richardson
authors.forename: Blackford
authors.initials: B
authors.lastname: Middleton
mesh_terms: D019985:Benchmarking; D020000:Decision Support Systems, Clinical; D006801:Humans; D019451:Information Management; D051188:Knowledge Bases; D058436:Knowledge Management; D017064:Process Assessment, Health Care; D011787:Quality of Health Care