Using an eight-dimensional model for studying socio-technical systems, a multidisciplinary team of investigators identified barriers and facilitators to clinical decision support (CDS) implementation in a community setting, the Mid-Valley Independent Physicians Association in the Salem, Oregon area. The team used the Rapid Assessment Process, which included nine formal interviews with CDS stakeholders, and observation of 27 clinicians. The research team, which has studied 21 healthcare sites of various sizes over the past 12 years, believes this site is an excellent example of an organization which is using a commercially available electronic-health-record system with CDS well. The eight-dimensional model proved useful as an organizing structure for the evaluation.
Keywords: Developing/using computerized provider order entry, improving the education and skills training of health professionals, developing/using clinical decision support (other than diagnostic) and guideline systems, social/organizational study, qualitative/ethnographic field study, knowledge representations, classical experimental and quasi-experimental study methods (lab and field), designing usable (responsive) resources and systems, statistical analysis of large datasets, discovery and text and data mining methods, automated learning, human–computer interaction and human-centered computing, qualitative/ethnographic field study, clincal decision support, machine learning, knowledge bases, clinical decision support, ambulatory care, ambulatory care