Building and Maintaining Trust in Clinical Decision Support: Recommendations From the Patient-Centered CDS Learning Network

Joshua E Richardson 1, Blackford Middleton 2, Jodyn E Platt 3, Barry H Blumenfeld 4

Affiliations

PMID: 32313835
PMCID: PMC7156865
DOI: 10.1002/lrh2.10208

Free PMC article

Abstract

Knowledge artifacts in digital repositories for clinical decision support (CDS) can promote the use of CDS in clinical practice. However, stakeholders will benefit from knowing which they can trust before adopting artifacts from knowledge repositories. We discuss our investigation into trust for knowledge artifacts and repositories by the Patient-Centered CDS Learning Network's Trust Framework Working Group (TFWG). The TFWG identified 12 actors (eg, vendors, clinicians, and policy makers) within a CDS ecosystem who each may play a meaningful role in prioritizing, authoring, implementing, or evaluating CDS and developed 33 recommendations distributed across nine "trust attributes." The trust attributes and recommendations represent a range of considerations such as the "Competency" of knowledge artifact engineers and the "Organizational Capacity" of institutions that develop and implement CDS. The TFWG findings highlight an initial effort to make trust explicit and embedded within CDS knowledge artifacts and repositories and thus more broadly accepted and used.

Keywords: decision support systems, clinical; health policy; learning health system; trust.

Conflict of interest statement

Dr Middleton receives salary as an employee and stock holder of Apervita, Inc, receives funding from the Gordon and Betty Moore Foundation research support, and is a consultant to the AHRQ‐funded Patient‐centered CDS Learning Network. All other authors report no potential conflicts of interest.