Arwen Bunce

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PURPOSE Federal incentives to adopt interoperable, certified electronic health records (EHRs) with electronic prescribing (e-prescribing) are motivating providers using older EHRs to transition to newer EHRs. The objective of this study was to describe, from the perspective of experienced EHR users, the transition from an older, locally developed EHR with(More)
BACKGROUND The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS) development and implementation and for knowledge management (KM) processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. METHODS Guided by the Multiple Perspectives Framework,(More)
OBJECTIVE To describe the activities performed by people involved in clinical decision support (CDS) at leading sites. MATERIALS AND METHODS We conducted ethnographic observations at seven diverse sites with a history of excellence in CDS using the Rapid Assessment Process and analyzed the data using a series of card sorts, informed by Linstone's Multiple(More)
BACKGROUND Integrated health care delivery systems devote considerable resources to developing quality improvement (QI) interventions. Clinics serving vulnerable populations rarely have the resources for such development but might benefit greatly from implementing approaches shown to be effective in other settings. Little trial-based research has assessed(More)
Using an eight-dimensional model for studying socio-technical systems, a multidisciplinary team of investigators identified barriers and facilitators to clinical decision support (CDS) implementation in a community setting, the Mid-Valley Independent Physicians Association in the Salem, Oregon area. The team used the Rapid Assessment Process, which included(More)
BACKGROUND Computerized clinical decision support (CDS) can help hospitals to improve healthcare. However, CDS can be problematic. The purpose of this study was to discover how the views of clinical stakeholders, CDS content vendors, and EHR vendors are alike or different with respect to challenges in the development, management, and use of CDS. METHODS(More)
BACKGROUND Little research has directly compared the effectiveness of implementation strategies in any setting, and we know of no prior trials directly comparing how effectively different combinations of strategies support implementation in community health centers. This paper outlines the protocol of the Study of Practices Enabling Implementation and(More)
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