Investigating Integration Of Computerized Decision Support Into Workflow Hsr&D Pres Feb 17 2011
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Investigating Integration Of Computerized Decision Support Into Workflow Hsr&D Pres Feb 17 2011

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Oral Presentation from AHRQ project at VA HSR&D Annual Meeting Feb 17, 2011

Oral Presentation from AHRQ project at VA HSR&D Annual Meeting Feb 17, 2011

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  • Two studies of the integration of clinical decision support tools Two days of observation at each site2-3 observers at each siteEach observer stayed with one provider through an average of two CDS interactions before observing another providerData analyzed using upward abstraction
  • Site 3 had a tool focused on coordination of care between primary and specialty careSite 2 had much on paper-electronic blend—had greatest use of paperSite 4 (PH) had more comments about functionality—was that related to positive or negative comments—comparable in advanced IT development to VA, but smaller system—huge IT research dept colocated with themUsability comments comparable across the sites similar even though very different systems—most were negativeLowest site on usability (RI) had templates, fewest negative commetns on usability probably related to using less for their jobRigidity—computer system, electronic medical record—forced you to do things, computer systemSite 1 and 3 had highest comments about rigidity (VA’s) and centrally controlled development strategyCoordination between specialty and primary care—tool developed as joint effort between primary and specialty care to foster scheduling, intake and provider and specialty and provider. Here coordination between intake and provider removed.Make a list of interpretations—do this again after we create figure from card sort and recommendations.
  • Interesting predominance of comments on technical system—is there an imbalance on technologically driven system, or was that the focus of the observations?Site 1 West HavenSite 2 RISite 3 Columbia VASite 4 PartnersCould this reflect frequency due to additional capturing of codesSite 1 had 2 peopleSite 2 had 3 peopleBig other data so detailed and made a point of recording all data regarding other stuff observed—for example, any time CRC mentioned, coded as other.Revised slide with only observations that were coded end of FTF session…1 page list of most important results and themesCreate graph of that card sort…4 recommendations that fell under the card sort, show proportion by siteMade up of codes under each of those strategies
  • Site 3 had a tool focused on coordination of care between primary and specialty careSite 2 had much on paper-electronic blend—had greatest use of paperSite 4 (PH) had more comments about functionality—was that related to positive or negative comments—comparable in advanced IT development to VA, but smaller system—huge IT research dept colocated with themUsability comments comparable across the sites similar even though very different systems—most were negativeLowest site on usability (RI) had templates, fewest negative commetns on usability probably related to using less for their jobRigidity—computer system, electronic medical record—forced you to do things, computer systemSite 1 and 3 had highest comments about rigidity (VA’s) and centrally controlled development strategyCoordination between specialty and primary care—tool developed as joint effort between primary and specialty care to foster scheduling, intake and provider and specialty and provider. Here coordination between intake and provider removed.Make a list of interpretations—do this again after we create figure from card sort and recommendations.

Investigating Integration Of Computerized Decision Support Into Workflow Hsr&D Pres Feb 17 2011 Investigating Integration Of Computerized Decision Support Into Workflow Hsr&D Pres Feb 17 2011 Presentation Transcript