Towards a Maturity Model for Clinical Decision Support Operations.

TitleTowards a Maturity Model for Clinical Decision Support Operations.
Publication TypeJournal Article
Year of Publication2019
AuthorsOrenstein EW, Muthu N, Weitkamp AO, Ferro DF, Zeidlhack MD, Slagle J, Shelov E, Tobias MC
JournalAppl Clin Inform
Volume10
Issue5
Pagination810-819
Date Published2019 Oct
ISSN1869-0327
Abstract

Clinical decision support (CDS) systems delivered through the electronic health record are an important element of quality and safety initiatives within a health care system. However, managing a large CDS knowledge base can be an overwhelming task for informatics teams. Additionally, it can be difficult for these informatics teams to communicate their goals with external operational stakeholders and define concrete steps for improvement. We aimed to develop a maturity model that describes a roadmap toward organizational functions and processes that help health care systems use CDS more effectively to drive better outcomes. We developed a maturity model for CDS operations through discussions with health care leaders at 80 organizations, iterative model development by four clinical informaticists, and subsequent review with 19 health care organizations. We ceased iterations when feedback from three organizations did not result in any changes to the model. The proposed CDS maturity model includes three main "pillars": "Content Creation," "Analytics and Reporting," and "Governance and Management." Each pillar contains five levels-advancing along each pillar provides CDS teams a deeper understanding of the processes CDS systems are intended to improve. A "roof" represents the CDS functions that become attainable after advancing along each of the pillars. Organizations are not required to advance in order and can develop in one pillar separately from another. However, we hypothesize that optimal deployment of preceding levels and advancing in tandem along the pillars increase the value of organizational investment in higher levels of CDS maturity. In addition to describing the maturity model and its development, we also provide three case studies of health care organizations using the model for self-assessment and determine next steps in CDS development.

DOI10.1055/s-0039-1697905
Alternate JournalAppl Clin Inform
PubMed ID31667818
PubMed Central IDPMC6821535