This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: M1822v1 12/4/365    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Teich, J. M. Search for Related Content PubMed PubMed Citation Articles by Teich, J. M.

Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan

Report of the Joint Clinical Decision Support Workgroup

Affiliations of the authors: Healthvision, Waltham, MA (JMT); Department of Emergency Medicine, Brigham and Women's Hospital and Harvard University, Boston, MA (JMT); Thomson Micromedex, Denver, CO (JAO); Department of Medicine, University of Pennsylvania Health System, Philadelphia, PA (JAO, EAP); Northwest Permanente, PC, Portland, OR (DFS); Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Sciences University, Portland, OR (DFS); Department of Medicine, Cedars-Sinai Medical Center, University of California, Los Angeles, CA (RAJ).

Correspondence and reprints: Jonathan M. Teich, MD, PhD, Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; e-mail: <jteich{at}harvard.edu>.

Received for publication: 03/08/05; accepted for publication: 03/23/05.

Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus white paper, we set forth recommendations and action plans in three critical domains: (1) advances in system capabilities, including basic and advanced sets of CDS interventions and knowledge, supporting database elements, operational features to improve usability and measure performance, and management and governance structures; (2) uniform standards, vocabularies, and centralized knowledge structures and services that could reduce rework by vendors and care providers, improve dissemination of well-constructed CDS interventions, promote generally applicable research in CDS methods, and accelerate the movement of new medical knowledge from research to practice; and (3) appropriate financial and legal incentives to promote adoption.

This article has been cited by other articles:

				W. R. Vincent, C. A. Martin, P. S. Winstead, K. M. Smith, J. Gatz, and D. A. Lewis Effects of a Pharmacist-to-Dose Computerized Request on Promptness of Antimicrobial Therapy J. Am. Med. Inform. Assoc., January 1, 2009; 16(1): 47 - 53. [Abstract] [Full Text] [PDF]

				M. D. Paterno, S. M. Maviglia, P. N. Gorman, D. L. Seger, E. Yoshida, A. C. Seger, D. W. Bates, and T. K. Gandhi Tiering Drug-Drug Interaction Alerts by Severity Increases Compliance Rates J. Am. Med. Inform. Assoc., January 1, 2009; 16(1): 40 - 46. [Abstract] [Full Text] [PDF]

				T. S. Field, P. Rochon, M. Lee, L. Gavendo, S. Subramanian, S. Hoover, J. Baril, and J. Gurwitz Costs Associated with Developing and Implementing a Computerized Clinical Decision Support System for Medication Dosing for Patients with Renal Insufficiency in the Long-term Care Setting J. Am. Med. Inform. Assoc., July 1, 2008; 15(4): 466 - 472. [Abstract] [Full Text] [PDF]

				P. M. Kilbridge and D. C. Classen The Informatics Opportunities at the Intersection of Patient Safety and Clinical Informatics J. Am. Med. Inform. Assoc., July 1, 2008; 15(4): 397 - 407. [Abstract] [Full Text] [PDF]

				J. M. Grossman, A. Gerland, M. C. Reed, and C. Fahlman Physicians' Experiences Using Commercial E-Prescribing Systems Health Aff., May 1, 2007; 26(3): w393 - w404. [Abstract] [Full Text] [PDF]

				J. A. Osheroff, J. M. Teich, B. Middleton, E. B. Steen, A. Wright, and D. E. Detmer A Roadmap for National Action on Clinical Decision Support J. Am. Med. Inform. Assoc., March 1, 2007; 14(2): 141 - 145. [Abstract] [Full Text] [PDF]

				G. J. Kuperman, R. M. Reichley, and T. C. Bailey Using Commercial Knowledge Bases for Clinical Decision Support: Opportunities, Hurdles, and Recommendations J. Am. Med. Inform. Assoc., July 1, 2006; 13(4): 369 - 371. [Full Text] [PDF]

				R. Tamblyn, A. Huang, Y. Kawasumi, G. Bartlett, R. Grad, A. Jacques, M. Dawes, M. Abrahamowicz, R. Perreault, L. Taylor, et al. The Development and Evaluation of an Integrated Electronic Prescribing and Drug Management System for Primary Care J. Am. Med. Inform. Assoc., March 1, 2006; 13(2): 148 - 159. [Abstract] [Full Text] [PDF]

				E. S. Berner, T. K. Houston, M. N. Ray, J. J. Allison, G. R. Heudebert, W. W. Chatham, J. I. Kennedy Jr., G. L. Glandon, P. A. Norton, M. A. Crawford, et al. Improving Ambulatory Prescribing Safety with a Handheld Decision Support System: A Randomized Controlled Trial J. Am. Med. Inform. Assoc., March 1, 2006; 13(2): 171 - 179. [Abstract] [Full Text] [PDF]

				W. F. Bria II Applied medical informatics for the chest physician: information you can use! Chest, February 1, 2006; 129(2): 446 - 451. [Abstract] [Full Text] [PDF]

				E. S. Berner and J. Moss Informatics Challenges for the Impending Patient Information Explosion J. Am. Med. Inform. Assoc., November 1, 2005; 12(6): 614 - 617. [Abstract] [Full Text] [PDF]

				D. E. Detmer and C. Safran AMIA's White Paper Policy Series on Timely Issues in Informatics J. Am. Med. Inform. Assoc., July 1, 2005; 12(4): 495 - 495. [Full Text] [PDF]

				R. A. Miller, R. M. Gardner, K. B. Johnson, and G. Hripcsak Clinical Decision Support and Electronic Prescribing Systems: A Time for Responsible Thought and Action J. Am. Med. Inform. Assoc., July 1, 2005; 12(4): 403 - 409. [Full Text] [PDF]