Two forms of health care information technology (HIT)—clinical decision support systems (CDSS) and ambulatory computerized physician order entry (ACPOE)—have been touted as powerful and sustainable interventions to improve quality of care. While good evidence exists to demonstrate the impact of inpatient computerized physician order entry (CPOE), the impact of ACPOE has not been well studied. Moreover, the adoption of CDSS and ACPOE systems remains slow, and their value proposition remains uncertain.

When ACPOE is linked with advanced CDSS, clinicians can be prompted at various points during their workflow about the desirable course of action and simultaneously be given the opportunity to execute the action (by ordering it) with minimal effort. We are testing the hypothesis that the value of ACPOE integrated with advanced CDSS lies not only in improved medication safety and guideline compliance, but also in improved efficiencies for the individual provider and the health care system.

This study’s specific aims are to: 

• evaluate the impact of integrating ACPOE with advanced CDSS on important safety and quality domains in the ambulatory setting, including medication monitoring, preventive care and chronic disease management, and test result follow-up;
  
  
• evaluate the impact of integrating ACPOE with advanced CDSS on organizational efficiency, physician workflow, and satisfaction;
  
  
• perform a cost-benefit analysis for the integration of ACPOE with advanced CDSS.