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An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial
Computerized clinical decision support (CDS) faces challenges to interoperability and scalability. Centralized, web-based solutions offer a mechanism to share the cost of CDS development, maintenance, and implementation across practices. Data standards have emerged to facilitate interoperability and...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994013/ https://www.ncbi.nlm.nih.gov/pubmed/32025639 http://dx.doi.org/10.1093/jamiaopen/ooz053 |
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author | Melnick, Edward R Holland, Wesley C Ahmed, Osama M Ma, Anthony K Michael, Sean S Goldberg, Howard S Lagier, Christian D’Onofrio, Gail Stachowiak, Tomek Brandt, Cynthia Solad, Yauheni |
author_facet | Melnick, Edward R Holland, Wesley C Ahmed, Osama M Ma, Anthony K Michael, Sean S Goldberg, Howard S Lagier, Christian D’Onofrio, Gail Stachowiak, Tomek Brandt, Cynthia Solad, Yauheni |
author_sort | Melnick, Edward R |
collection | PubMed |
description | Computerized clinical decision support (CDS) faces challenges to interoperability and scalability. Centralized, web-based solutions offer a mechanism to share the cost of CDS development, maintenance, and implementation across practices. Data standards have emerged to facilitate interoperability and rapid integration of such third-party CDS. This case report describes the challenges to implementation and scalability of an integrated, web-based CDS intervention for EMergency department-initiated BuprenorphinE for opioid use Disorder which will soon be evaluated in a trial across 20 sites in five healthcare systems. Due to limitations of current standards, security concerns, and the need for resource-intensive local customization, barriers persist related to centralized CDS at this scale. These challenges demonstrate the need and importance for future standards to support two-way messaging (read and write) between electronic health records and web applications, thus allowing for more robust sharing across health systems and decreasing redundant, resource-intensive CDS development at individual sites. |
format | Online Article Text |
id | pubmed-6994013 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-69940132020-02-05 An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial Melnick, Edward R Holland, Wesley C Ahmed, Osama M Ma, Anthony K Michael, Sean S Goldberg, Howard S Lagier, Christian D’Onofrio, Gail Stachowiak, Tomek Brandt, Cynthia Solad, Yauheni JAMIA Open Case Report Computerized clinical decision support (CDS) faces challenges to interoperability and scalability. Centralized, web-based solutions offer a mechanism to share the cost of CDS development, maintenance, and implementation across practices. Data standards have emerged to facilitate interoperability and rapid integration of such third-party CDS. This case report describes the challenges to implementation and scalability of an integrated, web-based CDS intervention for EMergency department-initiated BuprenorphinE for opioid use Disorder which will soon be evaluated in a trial across 20 sites in five healthcare systems. Due to limitations of current standards, security concerns, and the need for resource-intensive local customization, barriers persist related to centralized CDS at this scale. These challenges demonstrate the need and importance for future standards to support two-way messaging (read and write) between electronic health records and web applications, thus allowing for more robust sharing across health systems and decreasing redundant, resource-intensive CDS development at individual sites. Oxford University Press 2019-10-14 /pmc/articles/PMC6994013/ /pubmed/32025639 http://dx.doi.org/10.1093/jamiaopen/ooz053 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Report Melnick, Edward R Holland, Wesley C Ahmed, Osama M Ma, Anthony K Michael, Sean S Goldberg, Howard S Lagier, Christian D’Onofrio, Gail Stachowiak, Tomek Brandt, Cynthia Solad, Yauheni An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial |
title | An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial |
title_full | An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial |
title_fullStr | An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial |
title_full_unstemmed | An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial |
title_short | An integrated web application for decision support and automation of EHR workflow: a case study of current challenges to standards-based messaging and scalability from the EMBED trial |
title_sort | integrated web application for decision support and automation of ehr workflow: a case study of current challenges to standards-based messaging and scalability from the embed trial |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994013/ https://www.ncbi.nlm.nih.gov/pubmed/32025639 http://dx.doi.org/10.1093/jamiaopen/ooz053 |
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