Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior.

Full Abstract

Computerized physician order entry (CPOE) systems represent an important tool for providing clinical decision support. In undertaking this systematic review, our objective was to identify the features of CPOE-based clinical decision support systems (CDSSs) most effective at modifying clinician behavior. For this review, two independent reviewers systematically identified randomized controlled trials that evaluated the effectiveness of CPOE-based CDSSs in changing clinician behavior. Furthermore, each included study was assessed for the presence of 14 CDSS features. We screened 10,023 citations and included 11 studies. Of the 10 studies comparing a CPOE-based CDSS intervention against a non-CDSS control group, 7 reported a significant desired change in professional practice. Moreover, meta-regression analysis revealed that automatic provision of the decision support was strongly associated with improved professional practice (adjusted odds ratio, 23.72; 95% confidence interval, 1.75-infiniti). Thus, we conclude that automatic provision of decision support is a critical feature of successful CPOE-based CDSS interventions.

Author information

Author/s: Kawamoto, Kensaku (K); Lobach, David F (DF);

Affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA.

Grants: R01-HS10472 (Agency:AHRQ HHS) ; R03-HS10814 (Agency:AHRQ HHS) ; T32-GM07171 (Agency:NIGMS NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review

Journal: AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium (AMIA Annu Symp Proc), published in United States. (Language: eng)

Reference: 2003-; vol (issue ) : pp 361-5

Dates: Created 2004/01/19; Completed 2004/12/14; Revised 2009/03/09;

PMID: 14728195, status: MEDLINE (last retrieved date: 3/10/2009)

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