The various locations of decision-making are illustrated in Figure 3. How then do HRM strategies address the identified factors?
7 20 Therapeutic recommendations rather than diagnostic advice and computerised decision support at the time and location of decision making were also found to increase the chances of success.
These are automatic provision of decision support as part of clinician workflow; provision of recommendations rather than just assessments; provision of decision support at the time and location of decision making; and computer based [ 11].
Another, more recent systematic review found that successful CDSSs are computerised, provide decision support as part of clinician workflow, provide recommendations rather than just assessments, and provide decision support at the time and location of decision making[ 3].
Other factors to improve the use of decision support systems are: providing support at the time and location of decision making, giving a recommendation and using a computer [ 11, 12].
DSSs result in improved clinical practice if support is provided automatically as part of physicians' workflow, support is delivered at the time and location of decision making, actionable recommendations are provided and support is computer based [ 6].
Kawamoto et al. [ 10] showed that features of automatic provision for decision support as part of clinicians' workflow, provision recommendations rather than only assessments, provision decision support at the time and location of decision making, and computer-based decision support are closely correlated with decision support systems' abilities to significantly enhance patient care.
We believe such a model of decision support, providing recommendations rather than assessments, at the time and location of decision making, automatically as part of the clinical workflow, meet the criteria of a decision support system's ability to improve clinical practice [ 20].
Over 90% of clinician-directed CDS interventions evaluated in randomized controlled trials have significantly improved patient care, provided that the CDS was delivered automatically as a part of clinician workflow, offered at the time and location of decision making, recommended a specific course of action, and used a computer to generate the recommendation [ 29].
As mentioned before, four features are associated with the ability to improve clinical practice, it is part of the workflow, support is delivered at the time and location of decision making, actionable recommendations are provided and it is computer based [ 6].
"The location of decision-making in the economic world has shifted," Berle wrote, with the assistance of Gardiner Means, in a 1932 book, "The Modern Corporation and Private Property".
