The intersection of clinical decision support and electronic health record: A literature review

It is observed that clinical decision support (CDS) and electronic health records (EHR) should be integrated so that their contribution to improving the quality of health care is enhanced. In this paper, we present results from a review on the related literature. The aim of this review was to find out to what extent CDS developers have actually considered EHR integration in developing CDS. We have also investigated how various clinical standards are taken into account by CDS developers. We observed that there are few CDS development projects where EHR integration is taken into account. Also, the number of studies where various clinical standards are taken into consideration in developing CDS is surprisingly low especially for openEHR, the EHR standard we aimed for. The reasons for low adoption of openEHR are issues such as complex and huge specifications, shortcomings in educational aspects, low empirical focus and low support for developers. It is concluded that there is a need for further investigation to discover the reasons why the rate of integration of EHRs and CDS is not at an optimum level and mostly to discover why CDS developers are not keen to adopt clinical standards.