scholarly journals Compatibility of Family History Cancer Guidelines With Meaningful Use Standards

2017 ◽  
pp. 1-9
Author(s):  
Ayesha Aziz ◽  
Lance Pflieger ◽  
Nathaniel O’Connell ◽  
Joshua Schiffman ◽  
Brandon M. Welch
Keyword(s):  
Information Technology ◽  
Decision Support ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Decision Support ◽  
Meaningful Use ◽  
Clinical Decision ◽  
Cancer Type ◽  
Cancer Guidelines ◽  
Technology Systems

Purpose To evaluate the potential of implementing established family cancer guidelines as clinical decision support within meaningful use (MU)–compliant health information technology systems. Methods We conducted a systematic analysis of cancer guidelines involving family health history (FHx) published before 2015. By comparing existing cancer guideline statements to current MU FHx standard requirements, we determined whether the cancer guideline statements could be implemented as clinical decision support. For guidelines that could not implemented, we determined the primary reasons for incompatibility. Results A total of 531 statements from 55 guidelines published by 11 different organizations were reviewed and analyzed. Overall, 18% to 66% of guideline statements could or could not be implemented in MU-compliant health information technology systems, depending on which MU standard was used. Health Level Seven (HL7) models performed better than SNOMED models. Implementability of guideline statements varied by cancer type and guideline organizations. The greatest deficiencies in implementability of statements were largely a result of the fact that MU standards required only first-degree relatives and that FHx terms used in guidelines statements were ambiguous. Conclusion FHx cancer guidelines and MU-based systems vary widely and are mostly incompatible. We identified sources of incompatibility and made recommendations that could improve the implementability of FHx cancer guidelines. Our findings and recommendations can enhance the use of established FHx cancer risk guidelines in routine clinical workflows.

scholarly journals Informatics and interaction: Applying human factors principles to optimize the design of clinical decision support for sepsis

2019 ◽  
Vol 26 (1) ◽  
pp. 642-651
Author(s):  
Laura Schubel ◽  
Danielle L Mosby ◽  
Joseph Blumenthal ◽  
Muge Capan ◽  
Ryan Arnold ◽  
...  
Keyword(s):  
Information Technology ◽  
Decision Support ◽  
Human Factors ◽  
Organ Failure ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Decision Support ◽  
Clinical Care ◽  
Clinical Decision ◽  
Wide Range

In caring for patients with sepsis, the current structure of electronic health record systems allows clinical providers access to raw patient data without imputation of its significance. There are a wide range of sepsis alerts in clinical care that act as clinical decision support tools to assist in early recognition of sepsis; however, there are serious shortcomings in existing health information technology for alerting providers in a meaningful way. Little work has been done to evaluate and assess existing alerts using implementation and process outcomes associated with health information technology displays, specifically evaluating clinician preference and performance. We developed graphical model displays of two popular sepsis scoring systems, quick Sepsis Related Organ Failure Assessment and Predisposition, Infection, Response, Organ Failure, using human factors principles grounded in user-centered and interaction design. Models will be evaluated in a larger research effort to optimize alert design to improve the collective awareness of high-risk populations and develop a relevant point-of-care clinical decision support system for sepsis.

From Bench to Bed: Bridging from Informatics Theory to Practice

2014 ◽  
Vol 53 (06) ◽  
pp. 511-515 ◽  
Author(s):  
R. Haux ◽  
C. U. Lehmann
Keyword(s):  
Information Technology ◽  
Decision Support ◽  
Health Information Technology ◽  
Health Information ◽  
Hospital Admissions ◽  
Clinical Decision ◽  
Clinical Informatics ◽  
Documentation Quality ◽  
Theory To Practice ◽  
Complex Patient

SummaryBackground: In 2009, the journal Applied Clinical Informatics (ACI) commenced publication. Focused on applications in clinical informatics, ACI was intended to be a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of IMIA, the International Medical Informatics Association.Objectives: To explore, after five years, which congruencies and interdependencies exist in publications of these journals and to determine if gaps exist. To achieve this goal, major topics discussed in ACI and in MIM had to be analysed. Finally, we wanted to explore, whether the intention of publishing these companion journals to provide an information bridge from informatics theory to informatics practice and from practice to theory could be supported by this model. In this manuscript we will report on congruencies and interdependencies from practise to theory and on major topis in ACI. Further results will be reported in a second paper.Methods: Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 from these journals were indexed and analysed.Results: Hundred and ninety-six publications have been analysed (87 ACI, 109 MIM). In ACI publications addressed care coordination, shared decision support, and provider communication in its importance for complex patient care and safety and quality. Other major themes included improving clinical documentation quality and efficiency, effectiveness of clinical decision support and alerts, implementation of health information technology systems including discussion of failures and succeses. An emerging topic in the years analyzed was a focus on health information technology to predict and prevent hospital admissions and managing population health including the application of mobile health technology. Congruencies between journals could be found in themes, but with different focus in its contents. Interdependencies from practise to theory found in these publications, were only limited.Conclusions: Bridging from informatics theory to practise and vice versa remains a major component of successful research and practise as well as a major challenge.

Safe Use of Electronic Health Records and Health Information Technology Systems

2013 ◽  
Vol 9 (4) ◽  
pp. 177-189 ◽  
Author(s):  
Charles R. Denham ◽  
David C. Classen ◽  
Stephen J. Swenson ◽  
Michael J. Henderson ◽  
Thomas Zeltner ◽  
...  
Keyword(s):  
Information Technology ◽  
Electronic Health Records ◽  
Health Information Technology ◽  
Health Information ◽  
Health Records ◽  
Electronic Health ◽  
Technology Systems

scholarly journals Comparison of an oncology clinical decision-support system’s recommendations with actual treatment decisions

2021 ◽  
Author(s):  
Suthida Suwanvecho ◽  
Harit Suwanrusme ◽  
Tanawat Jirakulaporn ◽  
Surasit Issarachai ◽  
Nimit Taechakraichana ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Treatment Options ◽  
Stage Iv ◽  
Clinical Decision ◽  
Treatment Decisions ◽  
Therapeutic Options ◽  
Cancer Type ◽  
The Us ◽  
Rectal Cancers

Abstract Objective IBM(R) Watson for Oncology (WfO) is a clinical decision-support system (CDSS) that provides evidence-informed therapeutic options to cancer-treating clinicians. A panel of experienced oncologists compared CDSS treatment options to treatment decisions made by clinicians to characterize the quality of CDSS therapeutic options and decisions made in practice. Methods This study included patients treated between 1/2017 and 7/2018 for breast, colon, lung, and rectal cancers at Bumrungrad International Hospital (BIH), Thailand. Treatments selected by clinicians were paired with therapeutic options presented by the CDSS and coded to mask the origin of options presented. The panel rated the acceptability of each treatment in the pair by consensus, with acceptability defined as compliant with BIH’s institutional practices. Descriptive statistics characterized the study population and treatment-decision evaluations by cancer type and stage. Results Nearly 60% (187) of 313 treatment pairs for breast, lung, colon, and rectal cancers were identical or equally acceptable, with 70% (219) of WfO therapeutic options identical to, or acceptable alternatives to, BIH therapy. In 30% of cases (94), 1 or both treatment options were rated as unacceptable. Of 32 cases where both WfO and BIH options were acceptable, WfO was preferred in 18 cases and BIH in 14 cases. Colorectal cancers exhibited the highest proportion of identical or equally acceptable treatments; stage IV cancers demonstrated the lowest. Conclusion This study demonstrates that a system designed in the US to support, rather than replace, cancer-treating clinicians provides therapeutic options which are generally consistent with recommendations from oncologists outside the US.

scholarly journals IT-Enabled Clinical Decision Support: An Empirical Study on Antecedents and Mechanisms

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Rogier van de Wetering
Keyword(s):  
Clinical Practice ◽  
Decision Support ◽  
Health Information ◽  
Clinical Decision Support ◽  
Information Exchange ◽  
Large Scale ◽  
Health Information Exchange ◽  
Clinical Decision ◽  
Future Research ◽  
Cross Sectional

Modern hospitals increasingly make use of innovations and information technology (IT) to improve workflow and patient’s clinical journey. Typical innovative solutions include patient records and clinical decision support systems to enhance the process of decision making by doctors and other healthcare practitioners. However, currently, it remains unclear how hospitals could facilitate and enable such a decision support capability in clinical practice. We ground our work on the resource-based view of the firm and put forth the notion of IT-enabled capabilities which emphasizes critical IT investment and capability development areas that hospitals could exploit in their quest to improve clinical decision support. We develop a research model that explains how “health information exchange” and enhanced “information capability” collectively drive a hospital’s “clinical decision support capability.” We used partial least squares path modeling on large-scale cross-sectional data from 720 European hospitals. Outcomes suggest that health information exchange positively impacts information capability. In turn, information capability complementary partially mediates the relationship between information exchange and clinical decision support. Hence, this research contributes to the literature on clinical decision support and provides valuable insights into how to support such innovative technologies and capabilities in clinical practice. We conclude with a discussion and conclusion. Also, we outline the inherent limitations of this study and outline directions for future research.

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