Translating Research into Practice: Organizational Issues in Implementing Automated Decision Support for Hypertension in Three Medical Centers

Geriatrics Research Education and Clinical Center, 182 B, VA Palo Alto Health Care System, 3801 Miranda Avenue, CA 94304, USA.
Journal of the American Medical Informatics Association (Impact Factor: 3.5). 09/2004; 11(5):368-76. DOI: 10.1197/jamia.M1534
Source: PubMed


Information technology can support the implementation of clinical research findings in practice settings. Technology can address the quality gap in health care by providing automated decision support to clinicians that integrates guideline knowledge with electronic patient data to present real-time, patient-specific recommendations. However, technical success in implementing decision support systems may not translate directly into system use by clinicians. Successful technology integration into clinical work settings requires explicit attention to the organizational context. We describe the application of a "sociotechnical" approach to integration of ATHENA DSS, a decision support system for the treatment of hypertension, into geographically dispersed primary care clinics. We applied an iterative technical design in response to organizational input and obtained ongoing endorsements of the project by the organization's administrative and clinical leadership. Conscious attention to organizational context at the time of development, deployment, and maintenance of the system was associated with extensive clinician use of the system.

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    • ". Other methods, such as the use of electronic data banks [32] or prescription data [33] "
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    08/2013; 6(4):307-315. DOI:10.1016/j.jiph.2013.02.003
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    • "They found that the systems that provide decision support as part of clinical workflow, at the time and location of decision making, as well as those that provide recommendations rather than only assessments, were associated with higher success rates[7]. In addition, the integration of other systems such as Computerised Provider Order Entry (CPOE) with the CDSS [15]; seeking clinicians’ opinion about the system [10]; and improving technical infrastructure [25] are all reported as facilitators to clinicians’ adoption of CDSS. "
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