Decision Support

Decision Support Engagement Area

Decision Support

Clinical decision support (CDS) equips providers with tools to assist in the delivery of best health care practices through optional computerized recommendations. The Center for Knowledge Management (CKM) captures, organizes, and creates metadata schemas for local decision support residing within medical center systems with the goal of providing expertly curated evidence to support clinical practice.

Vanderbilt University Medical Center (VUMC) has a long history of creating unique biomedical informatics solutions to aid the clinical enterprise’s patient care mission, including clinical decision support. These CDS resources are embedded in the information systems, empowering clinicians to have timely and valuable resources at the point of care.

Working with data extracted from VUMC’s clinical systems, CKM externalizes and organizes information to apply robust metadata to facilitate discovery, identify relationships between content, append synthesized evidence, and provide a living archive of institutional knowledge. This approach promotes a deeper understanding of the knowledge and local practice embedded in the systems.

As part of VUMC’s transition to eStar, the clinical content interrelationships revealed through CKM’s effort were used to prioritize the creation of critical decision support content. Systems data includes rules from VUMC’s legacy computerized physician order entry system and indicators from the legacy electronic medical record systems. CKM further contributes to ongoing eStar efforts by providing supporting evidence for creation and maintenance of inpatient and outpatient ordersets.

To improve clinical decision-making and reduce unnecessary laboratory testing, CKM is building an evidence-based, context-rich, and comprehensive knowledge management solution for managing laboratory testing information at VUMC.

Our expertise will continue to be of value to the understanding of CDS in use at VUMC, especially as opportunities grow to incorporate more and increasingly complex CDS via community acceptance of standards.


  • DesAutels SJ, Giuse DA, Williams AM, Fox ZE, Blasingame MN, Giuse NB. (2019). EHR Implementation: Quantifying a Costly Communication and Knowledge Gap. Accepted for presentation at AMIA Clinical Informatics 2019: Atlanta, GA, 2019 May

  • DesAutels SJ. A Knowledge Management Effort to Evidentiate Laboratory Testing, Document Local Practice and Build a Shared Evidence Infrastructure. Department of Biomedical Informatics Seminar Series. Presented February 28, 2018.

  • Fox, ZE, Frakes ET, Su J, Blasingame MN, Epelbaum M, DesAutels J, Kou Q, Williams AM, Giuse NB. Applying Knowledge Management Best-Practices to Capture, Support, and Archive Systems-Embedded Clinical Decision Support Evidence. Medical Library Association Annual Meeting, Seattle, WA, May 2017.


Projects and Services


  • Health IT Leadership
  • Dario Giuse, Dr Ing, Associate Professor, Biomedical Informatics
  • Mary M. Zutter, MD, Vice President for Integrative Diagnostics; Professor, Pathology, Microbiology, and Immunology
  • William W. Stead, MD, Chief Strategy Information Officer; Professor, Biomedical Informatics
  • Megan Youngblood, MBA, Director, Strategic Programs
  • VUMC Lab Formulary Committee
  • VUMC Strategic Marketing