Issues in Computer-Based Decision Support in Public Health Illustrated Using Projects Involving Childhood Immunization

The article discusses issues that arise in implementing computer-based decision support using childhood immunization as a source of examples. The examples include (1) IMM/Serve, a program that provides patient-specific recommendations, (2) informatics tools developed to help validate IMM/Serve's knowledge and functionality, and (3) tools developed to explore how computers can help ensure immunization data quality. Issues discussed include the complexity of creating computer-based decision support, the need for a continuing process of revision and testing as the health field evolves over time, and the potential value of computer-based tools to assist in this process.