Clinical Decision Support: The Experience At Brigham And Women'S Hospital/Partners Healthcare

In this chapter, we review clinical decision support systems (CDSS) at Brigham and Women's Hospital (BWH), including design, implementation, and evaluation. BWH has over 40 years active experience in the development of clinical information systems. Here we focus specifically on BWH's work in assessing the impact of CDSS in critical areas of patient safety, quality, and cost outcomes, and offer generalizable lessons for current and future applications of CDSS. CDSS examined include both inpatient and outpatient systems, medication related, laboratory and radiology decision support as well as documentation-related CDSS, clinical reminders, and patient-centric applications. Also included are descriptions of studies on the impact on the user and cost-effectiveness of CDSS.