Deployment and User Adoption

Gaining user adoption of CDS systems is not an automatic “build it and they will come” process. CDS projects require thoughtful and ongoing efforts to incent user adoption, with focus on:

• Visible commitment of on-the-ground clinical guideline champions
• Provider education and training, (linked to CME) with live or computer-based methods
• Measurement and reporting of usage
• Automated reminders and feedback loops built into the CDS application
• Financial, regulatory, or legislative incentives
• Ongoing provider outreach visits

While clear clinical objectives define a CDS project, organizational support is critical for successful development, support and adoption. CHOP recommends an assessment of four organizational elements as key requirements in developing a comprehensive guideline-based CDS system.

• Mature EMR Implementation: A stable EMR implementation is critical to the success of a comprehensive guideline-based CDS system. EMRs should be active or "live" for at least one year.
• Clinician Training, Comfort, and Acclimation with the EMR: Indicators of clinical user population capable of adopting new forms of CDS are the status and success of EMR training programs, as well as EMR adoption and end-user satisfaction ratings.
• Stakeholder/Executive Support: Stakeholder support is essential to a successful, comprehensive guideline-based CDS system deployment.
• Clinician Buy-in: Clinician buy-in is the final element essential to organizational support.

• CDS Adoption Plan Example
• Nemours Asthma CDS Desktop Guide
• Yale Sub-Speciality: Adoption Lessons Learned
• Deployment Guide CHOP- page 44 (Yale)
• User Adoption Improvement Planning Framework