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Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.

Publication ,  Journal Article
Dullabh, P; Sandberg, SF; Heaney-Huls, K; Hovey, LS; Lobach, DF; Boxwala, A; Desai, PJ; Berliner, E; Dymek, C; Harrison, MI; Swiger, J; Sittig, DF
Published in: J Am Med Inform Assoc
June 14, 2022

OBJECTIVE: We conducted a horizon scan to (1) identify challenges in patient-centered clinical decision support (PC CDS) and (2) identify future directions for PC CDS. MATERIALS AND METHODS: We engaged a technical expert panel, conducted a scoping literature review, and interviewed key informants. We qualitatively analyzed literature and interview transcripts, mapping findings to the 4 phases for translating evidence into PC CDS interventions (Prioritizing, Authoring, Implementing, and Measuring) and to external factors. RESULTS: We identified 12 challenges for PC CDS development. Lack of patient input was identified as a critical challenge. The key informants noted that patient input is critical to prioritizing topics for PC CDS and to ensuring that CDS aligns with patients' routine behaviors. Lack of patient-centered terminology standards was viewed as a challenge in authoring PC CDS. We found a dearth of CDS studies that measured clinical outcomes, creating significant gaps in our understanding of PC CDS' impact. Across all phases of CDS development, there is a lack of patient and provider trust and limited attention to patients' and providers' concerns. DISCUSSION: These challenges suggest opportunities for advancing PC CDS. There are opportunities to develop industry-wide practices and standards to increase transparency, standardize terminologies, and incorporate patient input. There is also opportunity to engage patients throughout the PC CDS research process to ensure that outcome measures are relevant to their needs. CONCLUSION: Addressing these challenges and embracing these opportunities will help realize the promise of PC CDS-placing patients at the center of the healthcare system.

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Published In

J Am Med Inform Assoc

DOI

EISSN

1527-974X

Publication Date

June 14, 2022

Volume

29

Issue

7

Start / End Page

1233 / 1243

Location

England

Related Subject Headings

  • Patient-Centered Care
  • Medical Informatics
  • Humans
  • Decision Support Systems, Clinical
  • 46 Information and computing sciences
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
  • 09 Engineering
  • 08 Information and Computing Sciences
 

Citation

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Dullabh, P., Sandberg, S. F., Heaney-Huls, K., Hovey, L. S., Lobach, D. F., Boxwala, A., … Sittig, D. F. (2022). Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan. J Am Med Inform Assoc, 29(7), 1233–1243. https://doi.org/10.1093/jamia/ocac059
Dullabh, Prashila, Shana F. Sandberg, Krysta Heaney-Huls, Lauren S. Hovey, David F. Lobach, Aziz Boxwala, Priyanka J. Desai, et al. “Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.J Am Med Inform Assoc 29, no. 7 (June 14, 2022): 1233–43. https://doi.org/10.1093/jamia/ocac059.
Dullabh P, Sandberg SF, Heaney-Huls K, Hovey LS, Lobach DF, Boxwala A, et al. Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan. J Am Med Inform Assoc. 2022 Jun 14;29(7):1233–43.
Dullabh, Prashila, et al. “Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan.J Am Med Inform Assoc, vol. 29, no. 7, June 2022, pp. 1233–43. Pubmed, doi:10.1093/jamia/ocac059.
Dullabh P, Sandberg SF, Heaney-Huls K, Hovey LS, Lobach DF, Boxwala A, Desai PJ, Berliner E, Dymek C, Harrison MI, Swiger J, Sittig DF. Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan. J Am Med Inform Assoc. 2022 Jun 14;29(7):1233–1243.
Journal cover image

Published In

J Am Med Inform Assoc

DOI

EISSN

1527-974X

Publication Date

June 14, 2022

Volume

29

Issue

7

Start / End Page

1233 / 1243

Location

England

Related Subject Headings

  • Patient-Centered Care
  • Medical Informatics
  • Humans
  • Decision Support Systems, Clinical
  • 46 Information and computing sciences
  • 42 Health sciences
  • 32 Biomedical and clinical sciences
  • 11 Medical and Health Sciences
  • 09 Engineering
  • 08 Information and Computing Sciences