Overall Objectives and RationaleClinical decision support (CDS) “provides clinicians, staff, patients, or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care.” CDS is one of the most critical components of health information systems because they can improve patient outcomes and lead to higher-quality health care. With the adoption of electronic health record (EHR) systems reaching over 90% of health care settings in the U.S., unprecedented opportunities exist to improve the quality and value of health care through CDS interventions at the national scale. However, to improve patient outcomes, increase clinician efficiency, and reduce clinician burnout, CDS tools need to be designed and implemented according to best practices and disseminated across healthcare settings through standards-based approaches.
Course GoalTaught by national leaders with decades of practical experience in the design, development, implementation, and evaluation of CDS, this online and hands-on course teaches state-of-the-art principles and best practices to enable effective CDS. Topics include a review of the various types of CDS tools; principles of CDS governance and knowledge management; CDS technical architectures, standards (FHIR, SMART, CDS Hooks, Infobutton), tools (OpenInfobutton, OpenCDS); and CDS implementation and evaluation. The course has been offered for over 20 years as a part of the graduate program at the University of Utah Department of Biomedical Informatics, which has a five-decade long history of innovations in CDS.
The course is targeted at any individual who is interested in CDS, regardless of background or prior experience. The student cohort is multidisciplinary, with backgrounds in health care delivery, public health, computer science, biology, genetics, and information technology. Examples of roles that could benefit from this course include those engaged with CDS governance and implementation at health care or public health organizations, CDS designers/developers, health IT designers/developers, CDS researchers, and clinical/health services researchers interested in applying CDS in their research.
Course Structure Overview
This is a 16-week long, three credit-hour course organized in 14 modules. Each module covers a specific topic and includes recorded presentations, reading materials, a short weekly quiz, and a synchronous lab session. In addition, the course has three assignments and a semester-long group project. Weekly lab sessions are offered on Tuesdays at 7pm ET. Students can join either onsite at the Department of Biomedical Informatics or remotely via Web meeting. Lab sessions are recorded and posted to Canvas for those who cannot attend.
Course Outline – August - December 2020
|Module #||Module Title|
|Module 1||Course overview, introduction to clinical decision support|
|Module 2||Task and Workflow implications for CDS|
|Module 3||Effectiveness of CDS|
|Module 4||CDS Governance|
|Module 5||Knowledge management and alert fatigue|
|Module 6||CDS architecture|
|Module 7||CDS languages and standards|
|Module 8||SMART on FHIR and CDS Hooks|
|Module 9||Shared decision making and CDS considering patient preferences|
|Module 10||Public Health and CDS|
|Module 11||CDS to improve diagnosis making|
|Module 12||Challenges to adoption|
|Module 13||CDS on a national level|
|Module 14||Future of CDS|
|Group project – CDS system delivery and presentation|
Canvas, the University of Utah’s online teaching resource, is used to manage the course. Students will be given instructions to use Canvas after they enroll. All course materials, activities, and communication are delivered through Canvas.
At the completion of the course, students will be able to:
- • Describe different kinds of CDS tools and their relevance to clinical problems.
- • Apply current CDS architectures, standards and tools such as SMART on FHIR, CDS Hooks, HL7 Infobutton Standard, OpenInfobutton, and OpenCDS.
- • Develop a CDS tool following best CDS design practices.
- • Describe the challenges with effective CDS implementation and adoption, including potential pitfalls such as alert fatigue.
- • Plan the implementation and evaluation strategy for a CDS intervention.
The course has no required textbook.