title: Exploring a clinically friendly web-based approach to clinical decision support linked to the electronic health record: design philosophy, prototype implementation, and framework for assessment.
abstract: BACKGROUND
  Computer-based clinical decision support (CDS) is an important component of the electronic health record (EHR). As an increasing amount of CDS is implemented, it will be important that this be accomplished in a fashion that assists in clinical decision making without imposing unacceptable demands and burdens upon the provider's practice.
  
  
  OBJECTIVE
  The objective of our study was to explore an approach that allows CDS to be clinician-friendly from a variety of perspectives, to build a prototype implementation that illustrates features of the approach, and to gain experience with a pilot framework for assessment.
  
  
  METHODS
  The paper first discusses the project's design philosophy and goals. It then describes a prototype implementation (Neuropath/CDS) that explores the approach in the domain of neuropathic pain and in the context of the US Veterans Administration EHR. Finally, the paper discusses a framework for assessing the approach, illustrated by a pilot assessment of Neuropath/CDS.
  
  
  RESULTS
  The paper describes the operation and technical design of Neuropath/CDS, as well as the results of the pilot assessment, which emphasize the four areas of focus, scope, content, and presentation.
  
  
  CONCLUSIONS
  The work to date has allowed us to explore various design and implementation issues relating to the approach illustrated in Neuropath/CDS, as well as the development and pilot application of a framework for assessment.
authors.affiliation: VA Connecticut Healthcare System West Haven, CT United States ; Center for Medical Informatics Yale University School of Medicine New Haven, CT United States ; Department of Anesthesiology Yale University School of Medicine New Haven, CT United States.
authors.forename: Perry
authors.identifier: 0000-0002-5176-943X
authors.initials: P
authors.lastname: Miller
authors.affiliation: Baltimore VA Medical Center Baltimore, MD United States ; Department of Neurology University of Maryland School of Medicine Baltimore, MD United States.
authors.forename: Michael
authors.identifier: 0000-0001-8398-5404
authors.initials: M
authors.lastname: Phipps
authors.affiliation: Department of Medicine Yale University School of Medicine New Haven, CT United States.
authors.forename: Sharmila
authors.identifier: 0000-0001-9043-2760
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Center for Medical Informatics Yale University School of Medicine New Haven, CT United States.
authors.forename: Nallakkandi
authors.identifier: 0000-0002-2045-0872
authors.initials: N
authors.lastname: Rajeevan
authors.affiliation: VA Connecticut Healthcare System West Haven, CT United States.
authors.forename: Forrest
authors.identifier: 0000-0001-6866-1815
authors.initials: F
authors.lastname: Levin
authors.affiliation: Center for Medical Informatics Yale University School of Medicine New Haven, CT United States.
authors.forename: Sandra
authors.identifier: 0000-0001-6721-3834
authors.initials: S
authors.lastname: Frawley
authors.affiliation: VA Connecticut Healthcare System West Haven, CT United States ; Department of Neurology Yale University School of Medicine New Haven, CT United States.
authors.forename: Hajime
authors.identifier: 0000-0001-7965-3706
authors.initials: H
authors.lastname: Tokuno
keywords: Internet; clinical decision support systems; electronic health records; neuropathic pain; therapeutics