Affiliation: Yale University
- Evidence-based clinical decision supportR N Shiffman
Yale Center for Medical Informatics, 300 George St, Ste 501, New Haven, CT 06511 USA E mail
Yearb Med Inform 8:120-7. 2013..If not properly addressed, these challenges can limit the effectiveness of CDS, and potentially risk inaccurate or inappropriate interventions to clinicians...
- A draft framework for measuring progress towards the development of a National Health Information InfrastructureDean F Sittig
Department of Medical Informatics, Northwest Permanente, P C, Portland, OR, USA
BMC Med Inform Decis Mak 5:14. 2005..We describe a conceptual framework to help measure progress toward that goal...
- Building better guidelines with BRIDGE-Wiz: development and evaluation of a software assistant to promote clarity, transparency, and implementabilityRichard N Shiffman
Yale Center for Medical Informatics, New Haven, Connecticut, USA
J Am Med Inform Assoc 19:94-101. 2012....
- The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementationRichard N Shiffman
Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT, USA
BMC Med Inform Decis Mak 5:23. 2005..Implementability refers to a set of characteristics that predict ease of (and obstacles to) guideline implementation. Our objective is to develop and validate a tool for appraisal of implementability of clinical guidelines...
- A convocation of wizards: synergies at the intersection of child health care, public health, and information technologyRichard N Shiffman
Department of Pediatrics, Yale School of Medicine, Yale Center for Medical Informatics, New Haven, Connecticut, USA
J Public Health Manag Pract . 2004....
- Transition to a computer-based record using scannable, structured encounter formsR N Shiffman
Department of Pediatrics, Yale University School of Medicine, New Haven, Conn, USA
Arch Pediatr Adolesc Med 151:1247-53. 1997..To evaluate the quality of documentation and user satisfaction with a structured documentation system for pediatric health maintenance encounters, using scanned paper-based forms to generate an electronic medical record...
- Toward improved guideline quality: using the COGS statement with GEMRichard N Shiffman
Yale Center for Medical Informatics, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA
Stud Health Technol Inform 107:159-63. 2004..Once a guideline has been marked up according to the GEM hierarchy, its knowledge content can be reused in multiple ways...
- Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementationRichard N Shiffman
Yale Center for Medical Informatics, 300 George Street, Suite 501, New Haven, CT 06511, USA
J Am Med Inform Assoc 11:418-26. 2004..This work describes a process to systematize and make explicit the translation of document-based knowledge into workflow-integrated clinical decision support systems...
- Computer-based guideline implementation systems: a systematic review of functionality and effectivenessR N Shiffman
Center for Medical Informatics, Yale School of Medicine, New Haven, CT 06520 8009, USA
J Am Med Inform Assoc 6:104-14. 1999..There were 10 controlled trials (9 randomized) and 10 time-series correlational studies. Guideline adherence improved in 14 of 18 systems in which it was measured. Documentation improved in 4 of 4 studies...
- A design model for computer-based guideline implementation based on information management servicesR N Shiffman
Center for Medical Informatics, Yale School of Medicine, New Haven, CT 06520 8009, USA
J Am Med Inform Assoc 6:99-103. 1999..The authors provide examples of the eight services that make up the model from five evidence-based practice parameters developed by the American Academy of Pediatrics...
- Standardized reporting of clinical practice guidelines: a proposal from the Conference on Guideline StandardizationRichard N Shiffman
Yale University School of Medicine and Yale Center for Medical Informatics, New Haven, Connecticut, USA
Ann Intern Med 139:493-8. 2003..Most organizations that are active in guideline development found the component items to be comprehensive and to fit within their existing development methods...
- Information technology for children's health and health care: report on the Information Technology in Children's Health Care Expert Meeting, September 21-22, 2000R N Shiffman
Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, Connecticut 06520 8009, USA
J Am Med Inform Assoc 8:546-51. 2001....
- An approach to guideline implementation with GEMR N Shiffman
Yale Center for Medical Informatics, New Haven, CT, USA
Stud Health Technol Inform 84:271-5. 2001..goal is to devise a system that can be applied by local clinical domain experts, quality assurance experts, and information systems programmers without requiring trained informaticians and knowledge engineers to serve as intermediaries..
- GEM: a proposal for a more comprehensive guideline document model using XMLR N Shiffman
Yale University, New Haven, Connecticut, USA
J Am Med Inform Assoc 7:488-98. 2000..To develop a guideline document model that includes a sufficiently broad set of concepts to be useful throughout the guideline life cycle...
- A guideline implementation system using handheld computers for office management of asthma: effects on adherence and patient outcomesR N Shiffman
Department of Pediatrics, Yale School of Medicine, New Haven, CT 06520 8009, USA
Pediatrics 105:767-73. 2000..To evaluate effects on the process and outcomes of care brought about by use of a handheld, computer-based system that implements the American Academy of Pediatrics guideline on office management of asthma exacerbations...
- Dropping the baton during the handoff from emergency department to primary care: pediatric asthma continuity errorsAllen L Hsiao
Yale University School of Medicine, New Haven, CT, USA
Jt Comm J Qual Patient Saf 35:467-74. 2009..A study was undertaken to assess the COI and follow-up between a tertiary care pediatric emergency department (ED) and PCPs for pediatric patients seeking acute asthma treatment...
- The Yale Guideline Recommendation Corpus: a representative sample of the knowledge content of guidelinesTamseela Hussain
Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT 06511, USA
Int J Med Inform 78:354-63. 2009..We refer to this sample as the Yale Guideline Recommendation Corpus (YGRC)...
- Metadata-driven Delphi rating on the InternetAniruddha M Deshpande
Center for Medical Informatics, Yale University School of Medicine, PO Box 208009, New Haven, CT 06520 8009, USA
Comput Methods Programs Biomed 77:49-56. 2005..0), acceptable (median 4.5, IQR 4.0-5.0) and easily accessible (median 5, IQR 4.0-5.0). We conclude that Web-based Delphi rating for consensus development is a convenient and acceptable alternative to the traditional paper-based method...
- Electronic medical records in a sub-specialty practice: one asthma center's experienceConcettina Tolomeo
Yale School of Medicine, Pediatric Respiratory Medicine, New Haven, CT 06520 8064, USA
J Asthma 45:849-51. 2008..Prior to the EMR system, 4% received an asthma action plan upon discharge. After implementation of the EMR system, 58% received an asthma action plan upon discharge...
- Use of statistical analysis in the biomedical informatics literatureMatthew Scotch
Yale Center for Medical Informatics, Yale University, New Haven, Connecticut 06511, USA
J Am Med Inform Assoc 17:3-5. 2010..These results highlight the use of statistics in informatics and the need for biomedical informatics scientists to have, as a minimum, proficiency in descriptive and elementary statistics...
- Using a guideline-centered approach for the design of a clinical decision support system to promote smoking cessationRichard N Shiffman
Yale Center for Medical Informatics, Yale School of Medicine, New Haven, CT, USA
Stud Health Technol Inform 101:152-6. 2004..Action types were identified. Extracting the critical concepts from the narrative text facilitates clarification of necessary content. The guideline-centric approach promotes accurate translation of guideline knowledge...
- Take note(s): differential EHR satisfaction with two implementations under one roofRyan T O'Connell
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06511, USA
J Am Med Inform Assoc 11:43-9. 2004....
- How "should" we write guideline recommendations? Interpretation of deontic terminology in clinical practice guidelines: survey of the health services communityE A Lomotan
Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, Connecticut 06511, USA
Qual Saf Health Care 19:509-13. 2010..To describe the level of obligation conveyed by deontic terms (words such as "should", "may", "must" and "is indicated") commonly found in clinical practice guidelines...
- Improving diagnostic testing and reducing overuse of antibiotics for children with pharyngitis: a useful role for the electronic medical recordAndrea L Benin
Yale School of Medicine, Robert Wood Johnson Clinical Scholars Program, New Haven, CT, USA
Pediatr Infect Dis J 22:1043-7. 2003..The purpose of this study was to use an electronic medical record (EMR) to assess use of diagnostic testing and of antibiotics for pharyngitis in a pediatric outpatient setting and to target areas for improvement...
- Facilitating adherence to the tobacco use treatment guideline with computer-mediated decision support systems: physician and clinic office manager perspectivesTheodore W Marcy
Office of Health Promotion Research, University of Vermont College of Medicine, Burlington, VT 05401 3444, USA
Prev Med 41:479-87. 2005..We then assessed attitudes towards a computer-mediated clinical decision support system (CDSS) to gauge whether this type of intervention could support performance of the guideline...
- Developing a decision support system for tobacco use counselling using primary care physiciansTheodore W Marcy
Office of Health Promotion Research, and Vermont Cancer Center, University of Vermont College of Medicine, 1 South Prospect Street, Burlington, VT 05401, USA
Inform Prim Care 16:101-9. 2008..Clinical decision support systems (CDSS) have the potential to improve adherence to guidelines, but only if they are designed to work in the complex environment of ambulatory clinics as otherwise physicians may not use them...