Kawamanto Kensaku, Flynn Michael C, Kukhareva Polina, ElHalta David, Hess Rachel, Gregory Travis, Walls Chris, Wigren Angela M, Borbolla Damian, Bray Bruce E, Parsons Mary H, Clayson Brett L, Briley Melissa S, Stipelman Carole H, Taylor Dean, King Carrie S, Del Fiol Guilherme, Reese Thomas J, Weir Charlene R, Taft Teresa, Strong Micheal B
Departments of Biomedical Informatics.
Medicine.
AMIA Annu Symp Proc. 2018 Dec 5;2018:624-633. eCollection 2018.
There is limited guidance available in the literature for establishing clinical decision support (CDS) governance and improving CDS effectiveness in a pragmatic, resource-efficient manner. Here, we describe how University of Utah Health established enterprise CDS governance in 2015 leveraging existing resources. Key components of the governance include a multi-stakeholder CDS Committee that vets new requests and reviews existing content; a requirement that proposed CDS is actually desired by intended recipients; coordination with other governance bodies; basic data analytics to identify high-frequency, low-value CDS and monitor progress; active solicitation of user issues; the transition of alert and reminder content to other, more appropriate areas in the electronic health record; and the judicious use of experimental designs to guide decision-making regarding CDS effectiveness. In the three years since establishing this governance, new CDS has been continuously added while the overall burden of clinician-facing alerts and reminders has been reduced by 53.8%.
文献中关于以务实、资源高效的方式建立临床决策支持（CDS）治理并提高CDS有效性的指导有限。在此，我们描述了犹他大学健康中心如何在2015年利用现有资源建立企业CDS治理。治理的关键组成部分包括一个多利益相关方的CDS委员会，该委员会审查新请求并评估现有内容；要求拟议的CDS实际为预期接收者所需要；与其他治理机构协调；进行基本数据分析以识别高频、低价值的CDS并监测进展；积极征集用户问题；将警报和提醒内容转移到电子健康记录中的其他更合适的区域；以及明智地使用实验设计来指导关于CDS有效性的决策。自建立这种治理以来的三年里，新的CDS不断增加，而面向临床医生的警报和提醒的总体负担降低了53.8%。
