The guidelines and analysis provided are sufficiently general and they can be applicable to a variety of databases, in particular to data warehouse implementations, for decision support systems.
Focus group guides will be adapted from our previous research about barriers, facilitators and implementation strategies for decision support interventions [ 18].
In her survey among an interdisciplinary group of clinicians, Ruland identified several important features for the implementation of decision support systems in clinical practice.
Many of the barriers to implementation of decision aids for treatment decisions relate to 'process' aspects, which may be less relevant for trial decision aids due to a regulatory requirement to provide information in the informed consent process.
A group of investigators from the Group Health Cooperative reported high satisfaction among all stakeholders and reduced utilization of surgery and overall costs after implementation of decision aids for patients with hip and knee arthritis [ 16, 17].
Kennedy and colleagues reported significant potential savings for the UK healthcare system of $725 per patient after implementation of decision support intervention for women with menorrhagia.
22, 33, 34 An increase in cancer-specific training and widespread implementation of decision support tools for GPs may increase their confidence in identifying patients with potential cancer symptoms.
Applied research in this area has focused on the implementation of decision rules or algorithms for narrow, predefined patient groups, such as those presenting with chest pain, children with croup, or women with pyelonephritis.
49 52 The EVAT adapted the RE-AIM model and was organized into five sections: (1) reach; (2) adoption; (3) implementation; (4) outcomes for decision making; and (5) maintenance and institutionalization (www.projectguia.org/en/research_publications.html).html
Similar methodology has been followed for the examination of the purposes and reasons for the implementation of decisions related to the creation of intercultural relations and networks as well, taking Trieste, Italy as an example.
