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Review
. 2023 Aug;32(1):169-178.
doi: 10.1055/s-0043-1768722. Epub 2023 Jul 6.

The Impact of Clinical Decision Support on Health Disparities and the Digital Divide

Brian J Douthit  1 , Allison B McCoy  2   3 , Scott D Nelson  4   5   6
Affiliations
Review

The Impact of Clinical Decision Support on Health Disparities and the Digital Divide

Brian J Douthit et al. Yearb Med Inform. 2023 Aug.

Abstract

Objectives: This literature review summarizes relevant studies from the last three years (2020-2022) related to clinical decision support (CDS) and CDS impact on health disparities and the digital divide. This survey identifies current trends and synthesizes evidence-based recommendations and considerations for future development and implementation of CDS tools.

Methods: We conducted a search in PubMed for literature published between 2020 and 2022. Our search strategy was constructed as a combination of the MEDLINE®/PubMed® Health Disparities and Minority Health Search Strategy and relevant CDS MeSH terms and phrases. We then extracted relevant data from the studies, including priority population when applicable, domain of influence on the disparity being addressed, and the type of CDS being used. We also made note of when a study discussed the digital divide in some capacity and organized the comments into general themes through group discussion.

Results: Our search yielded 520 studies, with 45 included at the conclusion of screening. The most frequent CDS type in this review was point-of-care alerts/reminders (33.3%). Health Care System was the most frequent domain of influence (71.1%), and Blacks/African Americans were the most frequently included priority population (42.2%). Throughout the literature, we found four general themes related to the technology divide: inaccessibility of technology, access to care, trust of technology, and technology literacy.This survey revealed the diversity of CDS being used to address health disparities and several barriers which may make CDS less effective or potentially harmful to certain populations. Regular examinations of literature that feature CDS and address health disparities can help to reveal new strategies and patterns for improving healthcare.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Fig. 1
Fig. 1
PRISMA [ 24 ] diagram for screening results.
Table 1
Table 1
Counts and percentages of CDS category and target, domain of influence, and priority population for the 45 included studies
Table 2
Table 2
Abbreviated table of literature data extraction
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References

    1. Williams DR, Yan Y, Jackson JS, Anderson NB. Racial Differences in Physical and Mental Health: Socio-economic Status, Stress and Discrimination. J Health Psychol 1997;2(3):335-51. doi: 10.1177/135910539700200305. - PubMed
    1. Hill CV, Pérez-Stable EJ, Anderson NA, Bernard MA. The National Institute on Aging Health Disparities Research Framework. Ethn Dis 2015;25(3):245-54. doi: 10.18865/ed.25.3.245. - PMC - PubMed
    1. Gillispie V, Abrigo R. Racial Disparities in Healthcare. In: Conrad K, editor. Clinical Approaches to Hospital Medicine: Advances, Updates and Controversies. Springer International Publishing; 2022. p. 265-73.
    1. Saeed SA, Masters RM. Disparities in Health Care and the Digital Divide. Curr Psychiatry Rep 2021;23(9):61. doi: 10.1007/s11920-021-01274-4. - PMC - PubMed
    1. National Academies of Sciences. The State of Health Disparities in the United States. In: Baciu A, Negussie Y, Geller A, Weinstein JN, editors. Cover of Communities in Action Communities in Action: Pathways to Health Equity. Washington (DC): National Academies Press; 2017. - PubMed