Empirical research
Experience with Integrating Diagnostic Decision Support Software with Electronic Health Records: Benefits versus Risks of Information Sharing
Authors:
Michael M. Segal ,
SimulConsult
About Michael M.
MD, PhD
Alanna K. Rahm,
Geisinger Health System
About Alanna K.
PhD
Nathan C. Hulse,
Intermountain Healthcare
About Nathan C.
PhD
Janet L. Williams,
Geisinger Health System
About Janet L.
LGC
Gregory J. Moore,
Geisinger Health System
About Gregory J.
MD, PhD
Roger Gildersleeve,
Intelligent Medical Objects
About Roger
MD
Margie C. Sunderland,
Intelligent Medical Objects
About Margie C.
MD
Steven B. Bleyl,
Intermountain Healthcare
About Steven B.
MD, PhD
Peter Haug,
Intermountain Healthcare
About Peter
MD
Marc S. Williams
iiGeisinger Health System
About Marc S.
MD
Abstract
Introduction: Reducing misdiagnosis has long been a goal of medical informatics. Current thinking has focused on achieving this goal by integrating diagnostic decision support into electronic health records.
Methods: A diagnostic decision support system already in clinical use was integrated into electronic health record systems at two large health systems, after clinician input on desired capabilities. The decision support provided three outputs: editable text for use in a clinical note, a summary including the suggested differential diagnosis with a graphical representation of probability, and a list of pertinent positive and pertinent negative findings (with onsets).
Results: Structured interviews showed widespread agreement that the tool was useful and that the integration improved workflow. There was disagreement among various specialties over the risks versus benefits of documenting intermediate diagnostic thinking. Benefits were most valued by specialists involved in diagnostic testing, who were able to use the additional clinical context for richer interpretation of test results. Risks were most cited by physicians making clinical diagnoses, who expressed concern that a process that generated diagnostic possibilities exposed them to legal liability.
Discussion and Conclusion: Reconciling the preferences of the various groups could include saving only the finding list as a patient-wide resource, saving intermediate diagnostic thinking only temporarily, or adoption of professional guidelines to clarify the role of decision support in diagnosis.
How to Cite:
Segal MM, Rahm AK, Hulse NC, Wood G, Williams JL, Feldman L, et al.. Experience with Integrating Diagnostic Decision Support Software with Electronic Health Records: Benefits versus Risks of Information Sharing. eGEMs (Generating Evidence & Methods to improve patient outcomes). 2017;5(1):23. DOI: http://doi.org/10.5334/egems.244
Published on 06 Dec 2017.
Peer Reviewed
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