JMIR Publications

ABSTRACT

Background:

Patient-centered clinical decision support (PC CDS) exists on a continuum that reflects the degree to which its knowledge base, data, delivery, and use focus on patient needs and experiences. A new focus on value-based, whole-person care has resulted in broader development of PC CDS technologies, yet there is a limited information on how to measure their performance and effectiveness. This paper provides a new framework for measuring the performance of PC CDS technology and describes how the framework can be applied to illustrative use cases.

Objective:

This paper presents a new framework that incorporates patient-centered principles into traditional health information technology and clinical decision support (CDS) evaluation frameworks to create a unified guide to PC CDS performance measurement.

Methods:

We reviewed existing literature on health information technology, CDS, and PC CDS measurement and evaluation to develop the framework. We validated and refined the measurement framework through key informant interviews and input from an expert panel.

Results:

The PC CDS Performance Measurement Framework includes six domains: safe, timely, effective, efficient, equitable, and patient-centered. Each domain contains subdomains with example measures and approaches to patient-centeredness. The framework also describes different levels at which effects can be measured, for example, at the patient, clinician, organization, and population level.

Conclusions:

This framework can be used by researchers, health system leaders, informaticians, and patients to understand the full breadth of performance and impact of PC CDS technology. As the field of PC CDS matures, researchers and evaluators can build upon the framework to assess which components of PC CDS technologies work, whether PC CDS technologies are being used as anticipated, and whether the intended outcomes of delivering evidence-based, patient-centered care are being achieved.