title: Adaptation of a Published Risk Model to Point-of-care Clinical Decision Support Tailored to Local Workflow.
abstract: Electronic clinical decision support can bring newly published knowledge to the point of care. However, local organizational buy-in, support for team workflows, IT system ease of use and other sociotechnical factors are needed to promote adoption. We successfully implemented a multi-variate cardiac risk stratification model from another institution into ours. We recreated the model and integrated it into our workflow, accessing it from our EHR with patient-specific data and facilitating clinical documentation if the user accepts the model results. Our clinical leaders championed the change and led educational dissemination efforts. We describe the ad-hoc social and technical collaboration needed to build and deploy the tool. The tool complements a clinical initiative within a community of practice, and is correlated with appropriate use of nuclear imaging.
authors.affiliation: The Permanente Medical Group, Oakland, CA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Sobel
authors.affiliation: Kaiser Permanente Care Management Institute, Oakland, CA.
authors.forename: Craig C
authors.initials: CC
authors.lastname: Baker
authors.affiliation: The Permanente Medical Group, Oakland, CA.
authors.forename: David
authors.initials: D
authors.lastname: Levy
authors.affiliation: Kaiser Permanente Care Management Institute, Oakland, CA.
authors.forename: Carol H
authors.initials: CH
authors.lastname: Cain
mesh_terms: D020000:Decision Support Systems, Clinical; D006801:Humans; D019095:Point-of-Care Systems; D012306:Risk; D057188:Workflow