Five stages of CDS adoption journey
Stage 4: Implementation phase
Understanding what the process involves
Successful implementation is highly dependent on stakeholders actively participating in the planning, as well as design phases, to ensure workflow is supported in the various levels of the organisation.
Step 1: Strategy
Defining project scope
- A successful implementation begins with a well-defined project charter and goals. A clear definition of your problem statement (see “Discovery phase”) provides a good starting point.
Setting up project governance
- Establish a clinical governance structure, and identify the project working group.
- A project working group may consist of the following team members:
|Physician Champion||CMO, CMIO, Physician lead|
|Project Manager||Clinical or Informatics Project Manager|
|Custom Editors||Clinical Manager or Educator;|
Informatics Manager or Clinical Analyst (often Nurse Informaticist)
|Content Reviewers||Physician Subject Matter Expert, Registered Nurse, Interdisciplinary team (Clinical Nurse Specialist, Educator, Pharmacist, Respiratory, Dietician, etc.)|
|Nursing and/or Clinical Informatics Support Lead||IT Developer or Analyst|
|Catalogue Manager||IT Analyst or IT Developer|
The Elsevier Experience:
Our working team comprised of an executive project director, implementation project lead, clinical informatics specialist, technical implementation lead, development team, informatics team and content team. All ready to support you during this journey.
Step 2: Engagement
Planning and development
- This is when the project team reviews the workflow, project charter (goals, scope, governance, expectations), sets expectations of clinicians’ role and prepares the orders (content).
- Preparation and development of content should be tracked and managed to ensure any risks are identified that could impact the timeline or the project.
- During the review process, the project team may identify content that needs amending or localising or new orders (content) that need to be created.
- Orders (content) will then be reviewed/amended (as required) to align with clinical practice/workflow before moving to the content management system.
Step 3: Preparation
- This is the time for the client's project team to prepare a training environment and run a user testing and acceptance test. After that, the project team will move the content to the production environment.
- Before the project go-live, do a complete testing of the order sets and functionality. Be prepared for possible downtime.
- Communication is crucial to all the stakeholders who will be using the order sets.
Step 4 : Go-live
- There should be a robust post go-live plan defined by the project team, including technical quality assurance (QA) and clinical QA. Remember, this is not a pure IT project.
Step 5: Sustain and Optimise
- The project team should periodically review usage of the solution. Our recommendation is to do a 30-, 60-, 90-days review.
- If you are using Elsevier’s solutions, you can ask for time savings analysis pre- and post- go-live.
The time taken to develop and deploy CDS into an EHR platforms differs from solution to solution.
A typical deployment timeline for clinical decision support tools such as order sets and care planning take at least 18 weeks.
Other variables impacting timeline include:
- EHR vendor relationship
- Number of selected orders/topics
- Extent of localisation/customisation of content
Have questions? We have answers. For more information on our products and integration capabilities, please contact our Elsevier Solution Specialist.