Some tested processes and tools to improve the coordination of care across multiple health care settings, while others tried to improve patient care through innovative HIT, decision support tools, or changes to the composition of the health care workforce. Established as part of the Health Care Innovation Awards (HCIA) ( ) for Community Resource Planning, Prevention, and Monitoring, these awardees were very diverse in the types of organizations represented and the focus and scale of their interventions. In 2012, the Centers for Medicare & Medicaid Services (CMS) awarded $162 622 080 to 24 health care organizations to demonstrate impacts on health care quality, cost, and outcomes over a 3-year period. Of those characteristics, describe the ones that had the greatest effect on adoption for the 2 awardees. Our specific research aims were as follows:Įxamine specific framework elements and related constructs that affected adoption. In this work, we highlight the relevant factors that influenced adoption of 2 radiology CDS interventions in 2 care contexts. Identifying which elements of adoption and implementation in light of different contexts give rise to success and sustainability of an initiative can be valuable when deciding next steps in disseminating innovative health care solutions. Contexts can differ by the number of EHR systems and implementation sites involved, types of clinical settings, and key stakeholders’ experiences. The success of health information technology (HIT) adoption in clinical environments and by health care providers depends on appropriate management in the contexts in which such innovations are implemented. This work is a detailed comparison of 2 similar radiology CDS initiatives, which, despite their differing contexts, encountered many of the same hurdles in design and implementation in ensuring successful adoption. Although many articles in the literature describe the successes or failures of specific CDS initiatives, 1, 3, 4 some provide key factors in ensuring successful CDS adoption and implementation. 2 The CDS tools give health care providers specific recommendations on the optimal order for selecting and conducting imaging tests, such as X-rays or magnetic resonance imaging. Future stages of MU (now the Quality Payment Program) will require the integration of CDS for radiology exams. 1 Since the introduction of the Meaningful Use (MU) program, greater attention is being paid to CDS components of the electronic health record (EHR). Clinical decision support (CDS) tools have shown improvements in efficiency and accuracy for medication ordering by reducing medical errors, improving formulary adherence, and improving patient outcomes through better management of contraindications and allergic events.
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