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Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Improving routine use of clinical pathway decision support through integration of an EHR with a clinical library resource designed to provide evidence-based guidance within oncology workflows

Authors: Mary Ichiuji, Laura Asakura, Carol Cain, Nancy Aye, Tatjana Kolevska, David Chen, Farah Mohebpour Brasfield, Dinesh Kotak

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

The rapid evolution, complexity, and specialization of oncology treatment makes it challenging for physicians to provide care based on the latest and best evidence. We hypothesized that physicians would use evidence-based trusted care pathways if they were easy to use and integrated into clinical workflow at the point of care.

Methods

Within a large integrated care delivery system, we assembled clinical experts to define and update drug treatment pathways, encoded them as flowcharts in an online library integrated with the electronic medical record, communicated expectations that clinicians would use these pathways for every eligible patient, and combined data from multiple sources to understand usage over time.

Results

We were able to achieve > 75% utilization of eligible protocols ordered through these pathways within two years, with > 90% of individual oncologists having consulted the pathway at least once, despite no requirements or external incentives associated with pathway usage. Feedback from users contributed to improvements and updates to the guidance.

Conclusions

By making our clinical decision support easily accessible and actionable, we find that we have made considerable progress toward our goal of having physicians consult the latest evidence in their treatment decisions.
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Metadata
Title
Improving routine use of clinical pathway decision support through integration of an EHR with a clinical library resource designed to provide evidence-based guidance within oncology workflows
Authors
Mary Ichiuji
Laura Asakura
Carol Cain
Nancy Aye
Tatjana Kolevska
David Chen
Farah Mohebpour Brasfield
Dinesh Kotak
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-11018-8

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