A multi-layered framework for disseminating knowledge for computer-based decision support

Boxwala, Aziz A.; Rocha, Beatriz H.; Maviglia, Saverio M.; Kashyap, Vipul; Meltzer, Seth; Kim, Jihoon; Tsurikova, Ruslana; Wright, Adam; Paterno, Marilyn D.; Fairbanks, Amanda; Middleton, Blackford

doi:10.1136/amiajnl-2011-000334

Cited by 72 publications

(77 citation statements)

References 25 publications

(16 reference statements)

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“…2 3 Clinical decision support systems (CDSSs) that implement guidelines have been developed to facilitate the use of CPGs. [4][5][6] However, physicians do not always use such systems 7 because of barriers relating to CDSSs. 8 If we are to promote the use of CDSSs by physicians, we need to determine the best way to present the information via interfaces.…”

Section: Introductionmentioning

confidence: 98%

Comparison of two kinds of interface, based on guided navigation or usability principles, for improving the adoption of computerized decision support systems: application to the prescription of antibiotics

Tsopra

Jaı̈s

Venot

et al. 2014

J Am Med Inform Assoc

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The interface designed according to usability principles was perceived to be more usable and inspired greater confidence among physicians than the guided navigation interface. Consideration of usability principles in the construction of an interface--in particular 'effective information presentation', 'consistency', 'efficient interactions', 'effective use of language', and 'minimizing cognitive load'--seemed to improve perceived usability and confidence in the system.

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Section: Introductionmentioning

confidence: 98%

Comparison of two kinds of interface, based on guided navigation or usability principles, for improving the adoption of computerized decision support systems: application to the prescription of antibiotics

Tsopra

Jaı̈s

Venot

et al. 2014

J Am Med Inform Assoc

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show abstract

“…More recently, in [26] authors suggests to organize CG knowledge in four layers: free text, semi-structured data, structured data and executable data. In the same sense, in [27] propose to structure the clinical decisions into 14 steps for the sake of clarity.…”

Section: Related Workmentioning

confidence: 99%

What Do Doctors Need for Effective Adoption and Integration of Clinical Guidelines into Daily Practice?

Campos

García

Guillamon

et al. 2014

2014 IEEE International Conference on Healthcare Informatics

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Catheter-related bloodstream infection (CRBSI) is one of the major existing problems in Intensive Care Units (ICU). CRBSI has a high prevalence and its treatment is quite costly in time and medication. One of the essential efforts in the diagnosis and treatment of CRBSI is the use of existing Clinical Guidelines (CG). Nevertheless, its adoption and integration into daily practice is quite complex due to the lack of software tools that cover all the needs. Considering this problem, in this work we identify some of the needs detected in daily work, and we present two tools for ICUs that makes the introduction of CGs and patient's data visualization simple.As a first goal we propose to obtain a computerized model of the clinical guideline. Gewel is an application that allows the mapping of a textual CG into a workflow model. In this tool we propose a process that 1) organizes the parts of the textual document according to GEM, 2) maps concepts to the Electronic Health Record (EHR) system, called CH4, so that it can automatically retrieve data and send HL7 messages, 3) supports the design of a workflow model that assists the following up of the steps and the measure of adherence to the CG, and 4) according to Evidence Based Medicine principles, allows the doctors to trace from the task or decision point of the workflow to the exact part of the document where it was originated.Once the CG is computerized and integrated in the EHR, the next goal is to identify key clinical problems, such as CRBSI, and retrieve the relevant information from the EHR. Due to the big amount of the EHR data registered in an ICU, physician's attention should be drawn to the clinical information related to the problem to be solved. We propose a mobile application, called mProblemView, that permits to establish and visualize relations between the elements of the EHR in a Problem-Oriented EHR approach.

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“…Guidelines that follow the GEM encoding are theoretically more readily translatable to computerized form. Work done by the multi-stakeholder CDS Consortium [ 11 ] took a similar layered encoding approach to CDS rule specifi cations [ 7 ]. The CDS Consortium defi ned a 4-layer model, where the top layers focused on human readable specifi cation and the lower layers focused on executable forms of the value sets and rule logic.…”

Section: Knowledge Portability: Standards For Clinical Decision Supportmentioning

confidence: 99%

Clinical Decision Support: History and Basic Concepts

McCallie

2016

Health Informatics

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From the earliest implementations of electronic health records (EHR,) clinical decision support (CDS) has been seen as a key benefi t of the move to computerization. This chapter will review many of the advances in EHR-based CDS, but will also note where CDS has not yet fully lived up to its promise. Included in this chapter's overview are: the various types of CDS (patient safety, clinical reminders, guidance towards best practice, etc.); the main approaches used for encoding of the clinical knowledge that drives CDS (scripts, rules, guidelines, algorithms, etc.); the different technologies currently used to manage and deliver CDS advice (Arden MLM, expert systems, etc.); as well as aspects of clinicians' user experience of the clinicians who interact with the CDS (alert fatigue, etc.). Understanding where we have come from can help set the stage for the innovations that will be needed to deliver on CDS's full potential, which will be the focus of Chapter 28 .

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A multi-layered framework for disseminating knowledge for computer-based decision support

Abstract: The experience in using the framework and the preliminary evaluation indicate that this approach has promise in creating structured knowledge, to implement in CDS systems, that is usable across organizations.

Cited by 72 publications

References 25 publications

Comparison of two kinds of interface, based on guided navigation or usability principles, for improving the adoption of computerized decision support systems: application to the prescription of antibiotics

Comparison of two kinds of interface, based on guided navigation or usability principles, for improving the adoption of computerized decision support systems: application to the prescription of antibiotics

What Do Doctors Need for Effective Adoption and Integration of Clinical Guidelines into Daily Practice?

Clinical Decision Support: History and Basic Concepts

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