» Articles » PMID: 26958255

Adaptation of a Published Risk Model to Point-of-care Clinical Decision Support Tailored to Local Workflow

Overview
Date 2016 Mar 10
PMID 26958255
Authors
Affiliations
Soon will be listed here.
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.

References
1.
Mark D, Hlatky M, Harrell Jr F, Lee K, Califf R, Pryor D . Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med. 1987; 106(6):793-800. DOI: 10.7326/0003-4819-106-6-793. View

2.
Bero L, Grilli R, Grimshaw J, Harvey E, Oxman A, Thomson M . Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. The Cochrane Effective Practice and Organization of Care Review Group. BMJ. 1998; 317(7156):465-8. PMC: 1113716. DOI: 10.1136/bmj.317.7156.465. View

3.
Berg M . Patient care information systems and health care work: a sociotechnical approach. Int J Med Inform. 1999; 55(2):87-101. DOI: 10.1016/s1386-5056(99)00011-8. View

4.
Lauer M, Pothier C, Magid D, Smith S, Kattan M . An externally validated model for predicting long-term survival after exercise treadmill testing in patients with suspected coronary artery disease and a normal electrocardiogram. Ann Intern Med. 2007; 147(12):821-8. DOI: 10.7326/0003-4819-147-12-200712180-00001. View

5.
Moxey A, Robertson J, Newby D, Hains I, Williamson M, Pearson S . Computerized clinical decision support for prescribing: provision does not guarantee uptake. J Am Med Inform Assoc. 2010; 17(1):25-33. PMC: 2995634. DOI: 10.1197/jamia.M3170. View