Research

The SAFER guides: empowering organizations to improve the safety and effectiveness of electronic health records

With support from the Office of the National Coordinator for Health Information Technology (ONC), we used a rigorous, iterative process to develop a set of 9 self-assessment tools to optimize the safety and safe use of EHRs. These tools, referred to as the Safety Assurance Factors for EHR Resilience (SAFER) guides, could be used to self-assess safety and effectiveness of EHR implementations, identify specific areas of vulnerability, and create solutions and culture change to mitigate risks.

Matching identifiers in electronic health records: implications for duplicate records and patient safety

OBJECTIVE: To quantify the percentage of records with matching identifiers as an indicator for duplicate or potentially duplicate patient records in electronic health records in five different healthcare organisations, describe the patient safety issues that may arise, and present solutions for managing duplicate records or records with matching identifiers. METHODS: […]

Use of order sets in inpatient computerized provider order entry systems: a comparative analysis of usage patterns at seven sites

BACKGROUND: Many computerized provider order entry (CPOE) systems include the ability to create electronic order sets: collections of clinically related orders grouped by purpose. Order sets promise to make CPOE systems more efficient, improve care quality and increase adherence to evidence-based guidelines. However, the development and implementation of order sets […]

Clinical summarization capabilities of commercially-available and internally-developed electronic health records

OBJECTIVE: Clinical summarization, the process by which relevant patient information is electronically summarized and presented at the point of care, is of increasing importance given the increasing volume of clinical data in electronic health record systems (EHRs). There is a paucity of research on electronic clinical summarization, including the capabilities […]

Development and evaluation of a comprehensive clinical decision support taxonomy: comparison of front-end tools in commercial and internally-developed electronic health record systems

BACKGROUND: Clinical decision support (CDS) is a valuable tool for improving healthcare quality and lowering costs. However, there is no comprehensive taxonomy of types of CDS and there has been limited research on the availability of various CDS tools across current electronic health record (EHR) systems. OBJECTIVE: To develop and […]

Governance for clinical decision support: Case studies and recommended practices from leading institutions

Six recommended practices were identified in the area of governance, and four were identified in the area of content management. Key similarities and differences between the organizations studied were also highlighted.

Comparison of clinical knowledge management capabilities of commercially-available and leading internally-developed electronic health records

BACKGROUND: We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community […]

The state of the art in clinical knowledge management: an inventory of tools and techniques

PURPOSE: To explore the need for, and use of, high-quality, collaborative, clinical knowledge management (CKM) tools and techniques to manage clinical decision support (CDS) content. METHODS: In order to better understand the current state of the art in CKM, we developed a survey of potential CKM tools and techniques. We […]

Clinical decision support capabilities of commercially-available clinical information systems

BACKGROUND: The most effective decision support systems are integrated with clinical information systems, such as inpatient and outpatient electronic health records (EHRs) and computerized provider order entry (CPOE) systems. Purpose The goal of this project was to describe and quantify the results of a study of decision support capabilities in […]

Creating and sharing clinical decision support content with Web 2.0: issues and examples

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online […]