Clinical Informatics promotes and advances the use and usefulness of the longitudinal record of health and illness. To date, the electronic health record has been used primarily as a documentation and communication tool, but best value may be derived when CDS is integrated into the EHR “providing clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered and presented at appropriate times, to enhance health and health care” (Health IT.gov).
- Bringing clinical decision support (CDS) to the point of care via the EHR has the potential to personalize and optimize care delivery. Knowledge transformation activities, as well as information derived from knowledge discovery in the data warehouse will provide a source of information about best practices. Targets for decision support interventions will be determined in collaboration with the Director of Quality and Safety, the Director of Education, and clinical leadership
- Emerging principles of effective decision support design, implementation, and evaluation will be applied. In addition to alerts and reminders and order sets, we will implement data collection templates, flowcharts, infobuttons, and calculators where appropriate to support clinical practice.
- Implementation will be preceded by CDS localization activities. Workflow and barrier analysis, local coding and CDS design, will set the stage for activation of decision support. Ongoing measurement will gauge its success in influencing behavior.
- Use of clinical data standards helps to assure interoperability of the ACH systems themselves and will facilitate connection of the ACH data warehouse to the JHMI data trust and/or regional health information exchanges.
- Applying principles of human-computer interaction promotes design of EHR templates and CDS. Working with attending clinicians, residents, the clinical quality improvement and safety committees, we defines best practices for interviewing and documentation using computers that bolster the clinician-patient relationship.