Open, interoperable, and configurable clinical decision support modules for OpenMRS, OpenEMR, and beyond

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Project summary Although a clinical decision support system (CDSS) can be an effective tool in clinical settings, such systems can be irrelevant to current clinical practice without up-to-date CDSS rules. Managing and maintaining CDSS rules can be resource-intensive, even for large academic medical centers, which typically have more resources than small medical practices. Our parent R01 project (1R01GM138589) aims to leverage Semantic Web technology to enable reusable and portable CDSS rules and enable clinicians to independently manage and maintain CDSS rules. The goal of the parent R01 project is to use the OpenMRS and OpenEMR as examples to demonstrate feasibility. The administrative supplement project proposes transforming internal codes into ready-to-distribute modules of OpenMRS and OpenEMR. The administrative supplement project will benefit existing OpenMRS and OpenEMR communities, i.e., clinicians and patient populations. The major deliverables of the administrative supplement include ready-to-distribute CDSS modules with comprehensive functionalities, higher-quality documentation, instructions, and CDSS educational modules. In the parent R01 project, the necessary CDSS functionalities were planned to be developed and tested as internal codes without documentation or user instructions, nor was the educational component planned. Meanwhile, we continue to explore a more generic solution to the issues that can benefit clinicians and patients by enhancing clinical care services. We anticipate that the newly added CDSS modules will facilitate more consistent preventive services to the populations served by both systems. Due to our efforts, the modules’ clinician users can provide services in a self-sustainable manner. The two new modules can be used as CDSS teaching platforms to educate students and trainees about the life cycle and technical mechanisms of CDSS regarding its operation, configuration, management, maintenance, and monitoring. For medical and health students without access to operational electronic medical records (EMR) systems or CDSS, students can obtain CDSS experience via hands-on sessions using these modules. For computer science students, these modules can facilitate understanding of basic terms of clinical care within EMR contexts. We anticipate that the educational modules will (1) prepare future CDSS users and designers more comprehensively, (2) empower them to optimize the CDSS and maximize the full potential of CDSS, and (3) better prepare the future workforce for healthcare IT. In practical terms, our newly proposed project will benefit existing and future OpenMRS and OpenEMR users and their patients. This work will help us achieve our goal for the parent R01 project. The experience obtained through the work of the CDSS modules will help us understand the interoperability of CDSS rules conceptually, pinpoint the underlying issues of interoperability, and shed light on future directions in tackling interoperability on a larger scale.