Invited Commentary
May 23, 2011

Clinical Decision Support and Rich Clinical Repositories: A Symbiotic RelationshipComment on “Electronic Health Records and Clinical Decision Support Systems”

Author Affiliations

Author Affiliations: Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, Maryland.


Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Intern Med. 2011;171(10):903-905. doi:10.1001/archinternmed.2010.518

In this issue of the Archives, Romano and Stafford report on the effect of electronic health records (EHRs)—both with and without clinical decision support (CDS)—on physician adherence to evidence-based guidelines. They used data from the National Ambulatory Medical Care Survey1 (NAMCS) and the National Hospital Ambulatory Medical Care Survey2 (NHAMCS) to evaluate physician performance on 20 quality indicators. The results that Romano and Stafford found were dismal. The investigators observed no consistent difference in guideline adherence among providers who used paper medical records compared with those who used either an EHR alone or an EHR with CDS.

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