Component 5; Unit 7: History of Clinical Decision Support Systems

Component 5; Unit 7: History of Clinical Decision Support Systems

Description:

This unit describes the history of clinical decision support systems.

Objectives:

  1. Describe various types and structures of clinical decision support (CDS) systems.
  2. Discuss the evolution of clinical decision support from expert system research.
  3. Discuss the changes in focus of clinical decision support from the 1980s to the present.
  4. Discuss the change in architecture and mode of access of clinical decision support systems from the 1980s to the present.
  5. Describe some of the early clinical decision support systems.
  6. Discuss the historical challenges in implementing CDS.

Component 5; Unit 7; Lecture 7a comp5_unit7a_lecture_slides

What is CDS? (18:30): 1. Definition of clinical decision support (CDS); 2) Types of CDS; 3) “Classic” clinical decision support systems

Component 5; Unit 7; Lecture 7b comp5_unit7b_lecture_slides

Examples of Early CDS (14:29)

Component 5; Unit 7; Lecture 7c comp5_unit7c_lecture_slides

Evolution of CDS (19:05): Challenges to be overcome

Component 5; Unit 8

Suggested Readings

Berner ES. Clinical decision support systems: State of the art. AHRQ publication No. 09-0069-EF. Rockville, Maryland: Agency for Healthcare Research and Quality. June 2009.  Available from:  https://healthit.ahrq.gov/sites/default/files/docs/page/09-0069-EF_1.pdf  

Miller RA. Medical diagnostic decision support systems-past, present, and future: a threaded bibliography and brief commentary. J Am Med Inform Assoc 1994; 1(1):8-27.  Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC116181/

Osheroff JA, Teich JM, Middleton B, Steen EB, Wright A, Detmer DE. A roadmap for national action on clinical decision support, J Am Med Inform Assoc 2007; 14:141-145. Available from:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213467/

Wright A, Sittig DA. A four-phase model of the evolution of clinical decision support architectures. Int J Med Inform 2008; 77(10):641-649   Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627782/pdf/nihms68821.pdf

Additional Materials

Demonstration of DXplain CDS:  Massachusetts General Hospital. DXplain. [Homepage on the Internet]. 2008 [cited 2010 Jul 12]. Available from: http://dxplain.mgh.harvard.edu/dxp/dxp.sdemo.pl

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