Vision and challenges of Evidence-Based Health Informatics: a case study of a CPOE meta-analysis.

OBJECTIVE: To discuss, taking the example of a meta-analysis on computerized physician order entry (CPOE) systems, the special challenges of Evidence-Based Health Informatics, defined as the conscientious, explicit and judicious use of current best evidence when making decisions about introduction and operation of information technology in a given health care setting. METHODS: We conducted a case study by performing a systematic review and meta-analysis of CPOE studies. We collected and discussed the challenges we addressed and how they could be overcome. RESULTS: Challenges comprise the correct identification of published health informatics evaluation studies, the low reporting and study quality of studies, the problem of combining evidence from heterogeneous studies, and the problem of publication bias in health informatics. CONCLUSION: Based on our experiences while conducting the CPOE meta-analysis, we argue that we are still at the beginning of Evidence-Based Health Informatics. To overcome the discussed challenges, health informatics should strive for harmonized terminology, a study registry, reporting standards, financial or legal incentives for conducting studies, methods to combine evidence from quantitative and qualitative studies, and guidelines for conducting and publishing evaluation studies.