J Am Med Inform Assoc - Standard practices for computerized clinical decision support in community hospitals: a national survey.

Tópicos

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Resumo

JECTIVE: Computerized provider order entry (CPOE) with clinical decision support (CDS) can help hospitals improve care. Little is known about what CDS is presently in use and how it is managed, however, especially in community hospitals. This study sought to address this knowledge gap by identifying standard practices related to CDS in US community hospitals with mature CPOE systems.MATERIALS AND METHODS: Representatives of 34 community hospitals, each of which had over 5 years experience with CPOE, were interviewed to identify standard practices related to CDS. Data were analyzed with a mix of descriptive statistics and qualitative approaches to the identification of patterns, themes and trends.RESULTS: This broad sample of community hospitals had robust levels of CDS despite their small size and the independent nature of many of their physician staff members. The hospitals uniformly used medication alerts and order sets, had sophisticated governance procedures for CDS, and employed staff to customize CDS.DISCUSSION: The level of customization needed for most CDS before implementation was greater than expected. Customization requires skilled individuals who represent an emerging manpower need at this type of hospital.CONCLUSION: These results bode well for robust diffusion of CDS to similar hospitals in the process of adopting CDS and suggest that national policies to promote CDS use may be successful.

Resumo Limpo

jectiv computer provid order entri cpoe clinic decis support cds can help hospit improv care littl known cds present use manag howev especi communiti hospit studi sought address knowledg gap identifi standard practic relat cds us communiti hospit matur cpoe systemsmateri method repres communiti hospit year experi cpoe interview identifi standard practic relat cds data analyz mix descript statist qualit approach identif pattern theme trendsresult broad sampl communiti hospit robust level cds despit small size independ natur mani physician staff member hospit uniform use medic alert order set sophist govern procedur cds employ staff custom cdsdiscuss level custom need cds implement greater expect custom requir skill individu repres emerg manpow need type hospitalconclus result bode well robust diffus cds similar hospit process adopt cds suggest nation polici promot cds use may success

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