TY - CHAP
T1 - A Brief History of Clinical Decision Support. Technical, Social, Cultural, Economic, and Governmental Perspectives.
AU - Greenes, Robert
N1 - Funding Information:
MU criteria are seen by the US Centers for Medicare and Medicaid Services (CMS), the largest public funder of health care in the US, as a powerful lever to encourage compliance, because CMS reimbursements for health care can be tied to them. The Office of the National Coordinator for Health IT (ONC) is responsible for coordinating initiatives to promote adoption and MU. As part of the HITECH Act, it funded initiatives in every US state and territory to develop HIE capabilities, funded some 70 Regional Extension Centers to work with practices and hospitals to adopt and meaningfully use EHRs, and established a certification mechanism for EHR vendor products and attestation criteria for practices and hospitals to demonstrate their achievement of MU. It has also funded some university and community college-based health IT workforce development initiatives, a number of pilot Beacon communities to demonstrate advanced levels of coordination and use of data to improve health care quality, and four Strategic Healthcare Advanced Research Project (SHARP) projects focusing on research aimed at providing needed capabilities for secondary data reuse, component-based software reuse, cognition and decision making, and security methodologies. Another initiative tied to the SHARP grants (but funded by a National Institutes of Health agency) was aimed at developing methods for medical device integration. In addition, CMS has established a series of Innovation Fund grants aimed at promoting large-scale adoption of methods, including technologies, that will foster quality and efficiency in health care delivery. Other US agencies have developed funding mechanisms to advance other aspects of the grand challenges for health care transformation, including the Patient-Centered Outcomes Research Institute (PCORI), and the National Science Foundation and National Institutes of Health aimed at translational genomics, big data, and other large initiatives. Industry and private sector consortia are also mounting investments and initiatives. Thus we are seeing a long-sought ramp-up of both attention and investment in this area, largely beginning in the late 2000s.
PY - 2014/5
Y1 - 2014/5
N2 - This chapter provides a historical context for the current high degree of interest in clinical decision support systems. It focuses on two aspects of history: (1) The development and evolution of the scientific and technical basis for the field, in terms of the primary research methodologies that have been proposed, tested, refined, extended, and in some cases deployed and evaluated in operational settings; (2) Major social, cultural, economic, management, and governmental influences on health care providers, health care delivery organizations, and the health care public that have contributed to the current climate of enthusiasm and eagerness for wide deployment and usage of CDS, but also to some of the barriers to success. Some of these themes represent key dimensions of activity in CDS currently, whereas others are related more to the underlying research to create the databases or knowledge used in CDS, and still others are of interest mainly in terms of their historical influence on current approaches.
AB - This chapter provides a historical context for the current high degree of interest in clinical decision support systems. It focuses on two aspects of history: (1) The development and evolution of the scientific and technical basis for the field, in terms of the primary research methodologies that have been proposed, tested, refined, extended, and in some cases deployed and evaluated in operational settings; (2) Major social, cultural, economic, management, and governmental influences on health care providers, health care delivery organizations, and the health care public that have contributed to the current climate of enthusiasm and eagerness for wide deployment and usage of CDS, but also to some of the barriers to success. Some of these themes represent key dimensions of activity in CDS currently, whereas others are related more to the underlying research to create the databases or knowledge used in CDS, and still others are of interest mainly in terms of their historical influence on current approaches.
KW - Accountable Care Organization
KW - HITECH Act
KW - Information retrieval
KW - MEDLINE
KW - Meaningful Use (MU)
KW - Venn diagram
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U2 - 10.1016/B978-0-12-398476-0.00002-6
DO - 10.1016/B978-0-12-398476-0.00002-6
M3 - Chapter
AN - SCOPUS:84902056241
SN - 9780123984760
SP - 49
EP - 109
BT - Clinical Decision Support
PB - Elsevier Inc.
ER -