title: Using a service oriented architecture approach to clinical decision support: performance results from two CDS Consortium demonstrations.
abstract: The Clinical Decision Support Consortium has completed two demonstration trials involving a web service for the execution of clinical decision support (CDS) rules in one or more electronic health record (EHR) systems. The initial trial ran in a local EHR at Partners HealthCare. A second EHR site, associated with Wishard Memorial Hospital, Indianapolis, IN, was added in the second trial. Data were gathered during each 6 month period and analyzed to assess performance, reliability, and response time in the form of means and standard deviations for all technical components of the service, including assembling and preparation of input data. The mean service call time for each period was just over 2 seconds. In this paper we report on the findings and analysis to date while describing the areas for further analysis and optimization as we continue to expand our use of a Services Oriented Architecture approach for CDS across multiple institutions.
authors.affiliation: Clinical Informatics R&D, Partners HealthCare System, Inc., Brigham & Women's Hospital, Boston, MA, USA.
authors.forename: Marilyn D
authors.initials: MD
authors.lastname: Paterno
authors.forename: Howard S
authors.initials: HS
authors.lastname: Goldberg
authors.forename: Linas
authors.initials: L
authors.lastname: Simonaitis
authors.forename: Brian E
authors.initials: BE
authors.lastname: Dixon
authors.forename: Adam
authors.initials: A
authors.lastname: Wright
authors.forename: Beatriz H
authors.initials: BH
authors.lastname: Rocha
authors.forename: Harley Z
authors.initials: HZ
authors.lastname: Ramelson
authors.forename: Blackford
authors.initials: B
authors.lastname: Middleton
mesh_terms: D020000:Decision Support Systems, Clinical; D057286:Electronic Health Records; D006801:Humans; D020407:Internet; D016347:Medical Records Systems, Computerized; D017410:Practice Guidelines as Topic; D014481:United States; D016270:United States Agency for Healthcare Research and Quality