ABSTRACT
While clinical decision support (CDS) delivers much of the value from the electronic health record, obtaining that value can be difficult. This piece describes how to get value, in terms of quality, safety, and financial savings. A way to think about CDS is to divide it into two broad areas, getting the content right, and getting the delivery correct. To get value, both are critical – implementation science relates largely to delivery. While content is a prerequisite, both how it is delivered and what is done in the socio-technical context around delivery affect how likely it is to be accepted. For example, delivery is often accompanied by education and sometimes also by policy changes. The expected benefit also depends heavily how the warnings are delivered – whether they follow human factors principles in terms of how they appear and whether they are integrated into the user workflow. This piece uses a paper on experiences derived from implementation of CDS over many years to illustrate these lessons.
