Dissemination of child abuse clinical decision support: Moving beyond a single electronic health record
Autor: | Safiya Richardson, Isabel A. Barata, Nicholas A. Kuehnel, Rachel P. Berger, Linda Park, David A Feldstein, Joshua Ross, Dana Kaplan, Emily Heineman, Benjamin Eithun, Francesca Bullaro, Thomas G. McGinn, Amanda Palm, Barbara L Knox, Sundas Khan |
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Rok vydání: | 2021 |
Předmět: |
Child abuse
020205 medical informatics Computer science Health Informatics 02 engineering and technology Clinical decision support system Article 03 medical and health sciences 0302 clinical medicine Electronic health record Health care 0202 electrical engineering electronic engineering information engineering medicine Electronic Health Records Humans Child Abuse 030212 general & internal medicine Child business.industry Information technology Usability Decision Support Systems Clinical medicine.disease Hospitals Physical abuse Medical emergency business Order set |
Zdroj: | Int J Med Inform |
ISSN: | 1386-5056 |
Popis: | Background Child maltreatment is a leading cause of pediatric morbidity and mortality. We previously reported on development and implementation of a child abuse clinical decision support system (CA-CDSS) in the Cerner electronic health record (EHR). Our objective was to develop a CA-CDSS in two different EHRs. Methods Using the CA-CDSS in Cerner as a template, CA-CDSSs were developed for use in four hospitals in the Northwell Health system who use Allscripts and two hospitals in the University of Wisconsin health system who use Epic. Each system had a combination of triggers, alerts and child abuse-specific order sets. Usability evaluation was done prior to launch of the CA-CDSS. Results Over an 18-month period, a CA-CDSS was embedded into Epic and Allscripts at two hospital systems. The CA-CDSSs vary significantly from each other in terms of the type of triggers which were able to be used, the type of alert, the ability of the alert to link directly to child abuse-specific order sets and the order sets themselves. Conclusions Dissemination of CA-CDSS from one EHR into the EHR in other health care systems is possible but time-consuming and needs to be adapted to the strengths and limitations of the specific EHR. Site-specific usability evaluation, buy-in of multiple stakeholder groups and significant information technology support are needed. These barriers limit scalability and widespread dissemination of CA-CDSS. |
Databáze: | OpenAIRE |
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