blackford middleton


Lessons learned from implementing service-oriented clinical decision support at four sites: A qualitative study

OBJECTIVE: To identify challenges, lessons learned and best practices for service-oriented clinical decision support, based on the results of the Clinical Decision Support Consortium, a multi-site study which developed, implemented and evaluated clinical decision support services in a diverse range of electronic health records. METHODS: Ethnographic investigation using the rapid […]


Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts

OBJECTIVE: To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework. MATERIALS AND METHODS: As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders’ […]


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 […]


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 […]


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 […]