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

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This is a review for Kensaku Kawamoto, Tonya Hongsermeier, Adam Wright, Janet Lewis, Douglas S Bell, Blackford Middleton’s Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts [1].


Introduction

The Office of the National Coordinator for Health IT (ONC) has expressed interest in promoting a way for the United States healthcare industry to share various Clinical Decision Support (CDS) knowledge.

Methods

Various stakeholders of potential CDS knowledge sharing were identified. These stakeholders included EHR vendors, clinical content vendors, healthcare organizations, and clinical informatics subject matter experts. Emails were sent to these identified persons to participate in sharing their thoughts on how and if this CDS knowledge sharing would look like. 19 shareholders agreed and were given initial surveys. After the surveys were collected, the 19 participating stakeholders were further interviewed for further discussion.

Results

The authors abstracted five main themes from the feedback of the 19 stakeholders: 1. Prioritize and support the creation and maintenance of a national CDS knowledge sharing framework 2. Facilitate the development of high-value content and tooling, preferably in an open-source manner 3. Accelerate the development or licensing of required, pragmatic standards 4. Acknowledge and address medicolegal liability concerns 5. Establish a self-sustaining business model

Discussion

Although not everyone in the healthcare industry was included in the stakeholder survey or interviews, the ones that were involved make up a big chunk of the market share. Since these participants are influential in the healthcare world, the ONC should use these findings as a guideline in their work to establish a CDS knowledge sharing framework.

Commentary

In this article, the authors wanted to shed some light on what direction the ONC should take when addressing the need for a CDS sharing platform. Although we are a long way off from having every healthcare organization be able to provide their successes and learn from other's successes is something that still would take a large amount of effort and cooperation in the healthcare community, it could greatly strengthen our nation's healthcare delivery. If we could get our providers to be reminded of all the latest best practices and recommendations, even the most rural US hospital could perform outstanding care and I think that is definitely something worth putting a lot of work towards.

References

  1. This is a review for Kensaku Kawamoto, Tonya Hongsermeier, Adam Wright, Janet Lewis, Douglas S Bell, Blackford Middleton’s Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts. J Am Med Inform Assoc. 2013 Jan 1;20(1):199-207. doi: 10.1136/amiajnl-2012-000887. Epub 2012 Aug 4. http://www.ncbi.nlm.nih.gov/pubmed/22865671