@article{9846a9ad70f34720b7042b71275b6748,
title = "An implementation framework and a feasibility evaluation of a clinical decision support system for diabetes management in secondary mental healthcare using CogStack",
abstract = "BACKGROUND: Improvements to the primary prevention of physical health illnesses like diabetes in the general population have not been mirrored to the same extent in people with serious mental illness (SMI). This work evaluates the technical feasibility of implementing an electronic clinical decision support system (eCDSS) for supporting the management of dysglycaemia and diabetes in patients with serious mental illness in a secondary mental healthcare setting.METHODS: A stepwise approach was taken as an overarching and guiding framework for this work. Participatory methods were employed to design and deploy a monitoring and alerting eCDSS. The eCDSS was evaluated for its technical feasibility. The initial part of the feasibility evaluation was conducted in an outpatient community mental health team. Thereafter, the evaluation of the eCDSS progressed to a more in-depth in silico validation.RESULTS: A digital health intervention that enables monitoring and alerting of at-risk patients based on an approved diabetes management guideline was developed. The eCDSS generated alerts according to expected standards and in line with clinical guideline recommendations.CONCLUSIONS: It is feasible to design and deploy a functional monitoring and alerting eCDSS in secondary mental healthcare. Further work is required in order to fully evaluate the integration of the eCDSS into routine clinical workflows. By describing and sharing the steps that were and will be taken from concept to clinical testing, useful insights could be provided to teams that are interested in building similar digital health interventions.",
keywords = "Alerting, Clinical decision support, CogStack, Diabetes, EHealth, Monitoring, Pre-diabetes",
author = "Dipen Patel and Msosa, {Yamiko J} and Tao Wang and Mustafa, {Omar G} and Siobhan Gee and Julie Williams and Angus Roberts and Dobson, {Richard JB} and Fiona Gaughran",
note = "Funding Information: This work was supported by: (a) the Maudsley Charity; (b) the National Institute for Health Research{\textquoteright}s (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London, the Maudsley Charity and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King{\textquoteright}s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The authors would like to thank Dr Tom Werner (consultant psychiatrist at SLaM) for facilitating initial testing of the eCDSS in the CMHT setting and Dr Matt Butler (Core Trainee in psychiatry at SLaM) for his contribution to the in-silico validation. Funding Information: This work was supported by: (a) the Maudsley Charity; (b) the National Institute for Health Research?s (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King?s College London, the Maudsley Charity and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King?s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The authors would like to thank Dr Tom Werner (consultant psychiatrist at SLaM) for facilitating initial testing of the eCDSS in the CMHT setting and Dr Matt Butler (Core Trainee in psychiatry at SLaM) for his contribution to the in-silico validation. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = apr,
day = "14",
doi = "10.1186/s12911-022-01842-5",
language = "English",
volume = "22",
journal = "BMC medical informatics and decision making",
issn = "1472-6947",
publisher = "BioMed Central",
number = "1",
}
