title: Using computational modeling to assess the impact of clinical decision support on cancer screening improvement strategies within the community health centers.
abstract: Our conceptual model demonstrates our goal to investigate the impact of clinical decision support (CDS) utilization on cancer screening improvement strategies in the community health care (CHC) setting. We employed a dual modeling technique using both statistical and computational modeling to evaluate impact. Our statistical model used the Spearman's Rho test to evaluate the strength of relationship between our proximal outcome measures (CDS utilization) against our distal outcome measure (provider self-reported cancer screening improvement). Our computational model relied on network evolution theory and made use of a tool called Construct-TM to model the use of CDS measured by the rate of organizational learning. We employed the use of previously collected survey data from community health centers Cancer Health Disparities Collaborative (HDCC). Our intent is to demonstrate the added valued gained by using a computational modeling tool in conjunction with a statistical analysis when evaluating the impact a health information technology, in the form of CDS, on health care quality process outcomes such as facility-level screening improvement. Significant simulated disparities in organizational learning over time were observed between community health centers beginning the simulation with high and low clinical decision support capability.
authors: Indiana University School of Informatics (IUPUI), United States; University of North Carolina, Gillings School of Global Public Health, United States. Electronic address: tcarney@unc.edu.
authors: Timothy Jay
authors: TJ
authors: Carney
authors: Carnegie Mellon University, Computational Analysis of Social and Organizational Systems (CASOS), United States. Electronic address: gmorgan@cs.cmu.edu.
authors: Geoffrey P
authors: GP
authors: Morgan
authors: Indiana University School of Informatics (IUPUI), United States. Electronic address: jofjones@iupui.edu.
authors: Josette
authors: J
authors: Jones
authors: Indiana University School of Informatics (IUPUI), United States; Indiana University School of Nursing, United States. Electronic address: amcdanie@iupui.edu.
authors: Anna M
authors: AM
authors: McDaniel
authors: Indiana University School of Nursing, United States. Electronic address: mtweaver@iupui.edu.
authors: Michael
authors: M
authors: Weaver
authors: University of North Carolina, Gillings School of Global Public Health, United States. Electronic address: weiner@email.unc.edu.
authors: Bryan
authors: B
authors: Weiner
authors: VA HSR&D Center of Excellence on Implementing Evidence-based Practice, United States; Roudebush VA Medical Center Regenstrief Institute, Inc., United States; Division of General Internal Medicine, Indiana University School of Medicine, United States. Electronic address: dahaggst@iupui.edu.
authors: David A
authors: DA
authors: Haggstrom
mesh_terms: D003151:Community Health Centers / Q000706:statistics & numerical data*; D003198:Computer Simulation; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D015233:Models, Statistical; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
keywords: Cancer screening; Community health center; Computational; Modeling; Simulation; Systems-thinking