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Stanford Children's CMIO Talks Home-grown Clinical Decision Support

By Alexandra Wilson Pecci  
   July 25, 2017

Innovating on top of the EHR enables clinicians to get information about a patient, create clinical decision support, and integrate the data with the workflow, says Natalie M. Pageler, MD.

Clinical decision support is getting more personalized and nuanced all the time.

HealthLeaders recently talked with Natalie M. Pageler, MD, chief medical information officer at Stanford Children's Health and clinical associate professor of pediatric critical care and Stanford University, about some of the tools that the hospital is developing.

This is the first of two parts. The transcript below has been lightly edited.

HLM: Tell us a bit about your role.

Pageler: I am the liaison between the operational clinical side and the information services department. I oversee a large team of clinical informaticists, which is comprised of physicians, bedside nurses, and respiratory therapists. I also oversee the EHR training team.

HLM: You had a lot to do with creating a clinical decision support tool that is personalized for every patient. Can you describe it?

Pageler: We've had an approach that's involving web-based EHR clinical decision support tools. We really believe there is a huge opportunity to innovate on top of the EHR, and that by developing tools that are web-based, that have links with the EHR, we can get information about the patient, create clinical decision support, and then show that back in the context of the EHR so that it's integrated into the workflow.

A few specific examples: One is a new tool that we're creating called Premie BiliRecs that's being led by one of our neonatologists and clinical informatics physicians, Jonathan Palma, MD.

The tool takes information from the EHR about a premature baby's date of birth and their bilirubin levels, then processes that and returns guidance on how to treat that bilirubin level in that neonate. Bilirubin can be very toxic to neonates, and especially premature babies.

Alexandra Wilson Pecci is an editor for HealthLeaders.

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