Creating an immunization content database for knowledge management across clinical systems.

Purpose: A initiative at an academic medical center to create a single database of immunization-related content to inform the build and configuration of immunization-related knowledge assets across multiple clinical systems is described.

Methods: Semistructured expert interviews were conducted to ascertain the immunization information needs of the institution's clinical systems. Based on those needs, an immunization domain model constructed with data available from the Centers for Disease Control and Prevention (CDC) website was developed and used to analyze and compare current immunization-related content from CDC data sources with the content of the institution's clinical systems.

Rebuilding the Standing Prescription Renewal Orders.

Background: Managing prescription renewal requests is a labor-intensive challenge in ambulatory care. In 2009, Vanderbilt University Medical Center developed clinic-specific standing prescription renewal orders that allowed nurses, under specific conditions, to authorize renewal requests. Formulary and authorization changes made maintaining these documents very challenging.

Use of a computerized C-reactive protein (CRP) based sepsis evaluation in very low birth weight (VLBW) infants: a five-year experience.

Background: Serial C-reactive protein (CRP) values may be useful for decision-making regarding duration of antibiotics in neonates. However, established standard of practice for its use in preterm very low birth weight (<1500 g, VLBW) infants are lacking.

Objective: Evaluate compliance with a CRP-guided computerized decision support (CDS) algorithm and compare characteristics and outcomes of compliant versus non-compliant cases.