University of Twente Student Theses


The road from analytical CDSS invention to implementation in healthcare

Klein Koerkamp, R.M (2019) The road from analytical CDSS invention to implementation in healthcare.

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Abstract:Developments within analytics enhance the possibilities of predictions based on large datasets to optimize business processes, this is also applicable to healthcare. Clinical decision support systems (CDSS) powered by analytics can detect diseases and predict the development of the diseases. However, these CDSS remain within a research and development (R&D) environment and implementation is lacking. SAS, a supplier of analytics software, works together with UMC Utrecht to implement a CDSS called ‘Big data for small babies’ (BD4SB) which analyzes a vast amount of medical data to predict the probability on sepsis for premature born babies and supports the physicians’ decision-making process on mistering antibiotics. This system shows promising results, however, the transition from the R&D environment to implementation is complex since numerous stakeholders are involved who each experience different implementation barriers. This research set out to support this transition for BD4SB. To achieve this goal, this study explored the analytical CDSS environment with a technology roadmap to describe the problem context of implementing BD4SB. Furthermore, this study constructed the BD4SB implementation plan describing the (key)stakeholders, stakeholders’ barriers and accompanying solutions. To construct this implementation plan, a literature review was executed on the involved stakeholders with implementing CDSS to select the respondents for the interviews which consists of a methodologist, ethicist, management hospital, CDSS developer, IT department hospital, physician and regulatory entities. Furthermore, a literature review on the stakeholders’ barriers for implementing IT in healthcare provided input for the questionnaires of the interviews. Based on the literature reviews and the interviews, a thorough description of the stakeholders’ barriers and proposed solutions for implementing an analytical CDSS as BD4SB was created and categorized per stakeholder. This thorough description proves that the implementation environment of analytical CDSS is multidimensional and it emphasizes the magnitude of incorporating each stakeholders’ frame of reference to move towards implementing analytical CDSS in healthcare. The key stakeholder groups consist of the regulator, physician and developer. Firstly, advancements in technology have surpassed regulation, regulatory entities need to construct legislation to enable implementation of analytical CDSS as a medical device. Secondly, physicians’ lack of trust in analytical CDSS impairs implementation and should be mitigated by involving physicians in CDSS development. Thirdly, developers should execute technological solutions to improve data availability, integration, preparation and analysis of medical data to enable the analytical CDSS process within the required timespan to be clinically valuable. The contribution of this research is threefold: (1) scientific – the BD4SB implementation plan provides specification of and solutions for the known technical and people related barriers and for the absent or undervalued legal, ethical, validation and impact related barriers from literature, (2) business- the analytical CDSS environment technology roadmap provides guidance for product development, (3) business- the BD4SB implementation plan contains reasoning on implementing analytical CDSS from every stakeholders’ frame of reference and can be used by SAS in communication with the stakeholders.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Business Administration MSc (60644)
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