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Decision Support Engagement Area

Clinical Decision Support

Decision SupportClinical decision support (CDS) equips health care providers with computerized recommendations to assist in the delivery of optimal care. The Center for Knowledge Management (CKM) captures, organizes, and creates metadata schemas for local decision support residing within medical center systems and provides expertly curated evidence to support clinical practice.

Vanderbilt University Medical Center (VUMC) has a long history of creating unique biomedical informatics solutions to aid the clinical enterprise’s patient care mission, including clinical decision support. These CDS resources are embedded in our information systems, empowering clinicians to have timely and valuable resources at the point of care.

Working with data from VUMC’s clinical systems, CKM externalizes and organizes information to apply robust metadata to facilitate discovery, identify relationships between content, append synthesized evidence, and provide a living archive of institutional knowledge. This approach promotes a deeper understanding of the knowledge and local practice embedded in the systems.

For over two decades, CKM information scientists have provided supporting evidence for creation and maintenance of inpatient and outpatient ordersets built into VUMC’s clinical systems. As part of VUMC’s transition to eStar, CKM externalized rules from VUMC’s legacy computerized physician order entry system and dashboard indicators from the legacy electronic medical record systems. The clinical content interrelationships revealed through CKM’s effort were used to prioritize the creation of critical decision support content.

To improve clinical decision-making and reduce unnecessary laboratory testing, CKM provides filtered evidence syntheses regarding laboratory test clinical utility to support laboratory operational and formulary decision-making and inform the need for decision support. This evidence is stored, maintained, and updated in the VUMC Lab Tests Expert Guide & Data Repository developed by CKM.

Our expertise will continue to be of value to the understanding of CDS in use at VUMC, especially as opportunities grow to incorporate more and increasingly complex CDS via community acceptance of standards.


  • DesAutels SJ. A Knowledge Management Effort to Evidentiate Laboratory Testing, Document Local Practice and Build a Shared Evidence Infrastructure. Department of Biomedical Informatics Seminar Series. Presented February 28, 2018.

  • Fox, ZE, Frakes ET, Su J, Blasingame MN, Epelbaum M, DesAutels J, Kou Q, Williams AM, Giuse NB. Applying Knowledge Management Best-Practices to Capture, Support, and Archive Systems-Embedded Clinical Decision Support Evidence. Medical Library Association Annual Meeting, Seattle, WA, May 2017.