Key principles for a national clinical decision support knowledge sharing framework synthesis of insights from leading subject matter experts

This is a review for Kensaku Kawamoto, Tonya Hongsermeier, Adam Wright, Janet Lewis, Douglas S Bell, Blackford Middleton’s Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts .

Introduction

The Office of the National Coordinator for Health IT (ONC) has expressed interest in promoting a way for the United States healthcare industry to share various Clinical Decision Support (CDS) knowledge.

Methods

Various stakeholders of potential CDS knowledge sharing were identified. These stakeholders included EHR vendors, clinical content vendors, healthcare organizations, and clinical informatics subject matter experts. Emails were sent to these identified persons to participate in sharing their thoughts on how and if this CDS knowledge sharing would look like. 19 shareholders agreed and were given initial surveys. After the surveys were collected, the 19 participating stakeholders were further interviewed for further discussion.

Results

The authors abstracted five main themes from the feedback of the 19 stakeholders: 1. Prioritize and support the creation and maintenance of a national CDS knowledge sharing framework 2. Facilitate the development of high-value content and tooling, preferably in an open-source manner 3. Accelerate the development or licensing of required, pragmatic standards 4. Acknowledge and address medicolegal liability concerns 5. Establish a self-sustaining business model

Discussion

Although not everyone in the healthcare industry was included in the stakeholder survey or interviews, the ones that were involved make up a big chunk of the market share. Since these participants are influential in the healthcare world, the ONC should use these findings as a guideline in their work to establish a CDS knowledge sharing framework.

Commentary

In this article, the authors wanted to shed some light on the effectiveness of a CDS system in low to middle income countries. While I think this is interesting, this study only included one country’s result and I would caution not to base all low-middle income countries on these results.