Information Engineering and Workflow Design in a Clinical Decision Support System for Colorectal Cancer Screening in Iran


Background: Colorectal cancer is a major cause of morbidity and mortality throughout the world. Colorectalcancer screening is an optimal way for reducing of morbidity and mortality and a clinical decision support system(CDSS) plays an important role in predicting success of screening processes. DSS is a computer-based informationsystem that improves the delivery of preventive care services. The aim of this article was to detail engineering ofinformation requirements and work flow design of CDSS for a colorectal cancer screening program. Materials and
Methods: In the first stage a screening minimum data set was determined. Developed and developing countrieswere analyzed for identifying this data set. Then information deficiencies and gaps were determined by checklist. The second stage was a qualitative survey with a semi-structured interview as the study tool. A total of 15users and stakeholders’ perspectives about workflow of CDSS were studied. Finally workflow of DSS of controlprogram was designed by standard clinical practice guidelines and perspectives.
Results: Screening minimumdata set of national colorectal cancer screening program was defined in five sections, including colonoscopy dataset, surgery, pathology, genetics and pedigree data set. Deficiencies and information gaps were analyzed. Thenwe designed a work process standard of screening. Finally workflow of DSS and entry stage were determined.
Conclusions: A CDSS facilitates complex decision making for screening and has key roles in designing optimalinteractions between colonoscopy, pathology and laboratory departments. Also workflow analysis is useful toidentify data reconciliation strategies to address documentation gaps. Following recommendations of CDSSshould improve quality of colorectal cancer screening.