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Challenges, rewards in implementing clinical decision support

Clinical decision-support (CDS) systems are difficult to implement when stated goals and objectives are lacking, clinicians are reluctant, and the organization has a complicated structure. Once these barriers are overcome, however, those systems can help improve care.

So says the latest health IT study by the Agency for Healthcare Research and Quality (AHRQ).

Working with Brigham and Women’s Hospital in Boston and the New Haven, Conn.-based Yale School of Medicine, the AHRQ awarded each institution a $2 million, two-year grant starting in 2008. The two organizations conducted demonstration projects hoping to integrate CDS with electronic health record systems and assess whether they could work across multiple IT platforms and clinical sites and influence efficiency, outcomes and patient satisfaction.

Despite working on different aspects of CDS, the hospital and the medical school encountered similar barriers, according to the study’s results. Organizational culture is crucial, as is the willingness of medical staff to get on board with new systems.

“CDS is not just about technical content or technical design; CDS interventions also involve workflow,” the AHRQ wrote in its report. “It is clear from the empirical studies of CDS implementation and current recommendations for their design that integration with workflow is key to success.”

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