The Open Medical Informatics Journal


ISSN: 1874-4311 ― Volume 13, 2019

The Morningside Initiative: Collaborative Development of a Knowledge Repository to Accelerate Adoption of Clinical Decision Support

Robert Greenes*, 1, Meryl Bloomrosen2, Nancy E. Brown-Connolly3, Clayton Curtis4, Don E Detmer5, Robert Enberg6, Douglas Fridsma1, Emory Fry7, Mary K Goldstein8, Peter Haug9, Nathan Hulse9, Tonya Hongsermeier10, Saverio Maviglia10, Craig W Robbins11, Hemant Shah6
1 Arizona State University, Phoenix, AZ, USA
2 American Medical Informatics Association, Bethesda, MD, USA
3 Telemedicine and Advanced Technology Research Center (TATRC) of the US Army Medical Research Materiel Command, Frederick, MD, USA
4 Veterans Health Administration, Boston, MA, USA
5 American Medical Informatics Association, Bethesda, MD, USA
6 Henry Ford Health System, Detroit, MI, USA
7 Naval Health Research Center, San Diego, CA, USA
8 VA Palo Alto Health Care System, Palo Alto, CA, USA
9 Intermountain Healthcare, Salt Lake City, UT, USA
10 Partners Healthcare, Boston, MA, USA
11 Kaiser Permanente-Care Management Institute, Aurora, CO, USA


The Morningside Initiative is a public-private activity that has evolved from an August, 2007, meeting at the Morningside Inn, in Frederick, MD, sponsored by the Telemedicine and Advanced Technology Research Center (TATRC) of the US Army Medical Research Materiel Command. Participants were subject matter experts in clinical decision support (CDS) and included representatives from the Department of Defense, Veterans Health Administration, Kaiser Permanente, Partners Healthcare System, Henry Ford Health System, Arizona State University, and the American Medical Informatics Association (AMIA). The Morningside Initiative was convened in response to the AMIA Roadmap for National Action on Clinical Decision Support and on the basis of other considerations and experiences of the participants. Its formation was the unanimous recommendation of participants at the 2007 meeting which called for creating a shared repository of executable knowledge for diverse health care organizations and practices, as well as health care system vendors. The rationale is based on the recognition that sharing of clinical knowledge needed for CDS across organizations is currently virtually non-existent, and that, given the considerable investment needed for creating, maintaining and updating authoritative knowledge, which only larger organizations have been able to undertake, this is an impediment to widespread adoption and use of CDS. The Morningside Initiative intends to develop and refine (1) an organizational framework, (2) a technical approach, and (3) CDS content acquisition and management processes for sharing CDS knowledge content, tools, and experience that will scale with growing numbers of participants and can be expanded in scope of content and capabilities. Intermountain Healthcare joined the initial set of participants shortly after its formation. The efforts of the Morningside Initiative are intended to serve as the basis for a series of next steps in a national agenda for CDS. It is based on the belief that sharing of knowledge can be highly effective as is the case in other competitive domains such as genomics. Participants in the Morningside Initiative believe that a coordinated effort between the private and public sectors is needed to accomplish this goal and that a small number of highly visible and respected health care organizations in the public and private sector can lead by example. Ultimately, a future collaborative knowledge sharing organization must have a sustainable long-term business model for financial support.

Keywords: Clinical decision support, knowledge bases, knowledge sharing.

Article Information

Identifiers and Pagination:

Year: 2010
Volume: 4
First Page: 278
Last Page: 290
Publisher Id: TOMINFOJ-4-278
DOI: 10.2174/1874431101004010278

Article History:

Received Date: 14/10/2009
Revision Received Date: 6/8/2010
Acceptance Date: 6/8/2010
Electronic publication date: 14/12/2010
Collection year: 2010

© Greenes et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution, and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Biomedical Informatics, Arizona State University, 425 N. 5th Street, Phoenix, AZ 85004, USA; Tel: 602-827-2548; Fax: 602-827-2564; E-mail:

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