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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
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.
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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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