Use of a Proven Framework for Computer Decision Support within the Intermountain Healthcare Network.

Hospitalized patients in the U.S. do not always receive optimal care. In light of this, Computerized Decision Support (CDS) has been recommended to for the improvement of patient care. A number of methodologies, standards, and frameworks have been developed to facilitate the development and interoperability of computerized clinical guidelines and CDS logic. In addition, Health Information Exchange using Service-Oriented Architecture holds some promise to help realize that goal. We have used a framework at Intermountain Healthcare that employs familiar programming languages and technology to develop over 40 CDS applications during the past 13 years, which clinicians are dependent on each day. This paper describes the framework, technology, and CDS application development methods, while providing three distinct examples of applications that illustrate the need and use of the framework for patient care improvement. The main limitation of this framework is its dependence on point-to-point interfaces to access patient data. We look forward to the use of validated and accessible Service-Oriented Architecture to facilitate patient data access across diverse databases.