Clinical Decision Support System: Improving Health Outcomes

Analyze the requirements of the system and how this DSS is reducing medical errors and improving clinical practice.

Gawande’s (2015) article “Overkill,” suggests that physicians overprescribe drugs and tests which are ultimately unnecessary for patients. To eradicate such behavior, I would implement an electronic health record (EHR) with the following functions: Computerized provider order entry (CPOE) with a clinical decision support system (CDSS) to assist physicians/clinicians (stakeholders) in their medical practice or at hospitals. These functions will help to alleviate redundant tests and make suggestions about treatment. According to HealthIT.gov (2014), CDSS caters chiefly to drugs, laboratory testing, radiology procedures, and helpful clinical literature (HealthIT.gov, 2014).

1). Decision making by healthcare professionals is based on the assimilation of data, information and knowledge to support patient care. Organizing data, information and knowledge for the processing by computers is accomplished through the use of information technology and information structures (Newbold, 2008). The first level is data which “…are recorded (captured and stored) symbols and signal readings” (Liew, 2007, Definitions). Data is bits of information though to just have data is not meaningful to decision making. The second level is information which is organized, interpreted and communicated data between machines or humans. “Characteristics of quality information are: complete and clear in its descriptions, accurate, measurable, preferably by measurable objective means such as numbers, variable by independent observers, promptly entered, rapidly and easily available when needed, objective, rather than subjective, comprehensive, including all necessary information, appropriate to each user’s needs, clear and unambiguous, reliable, easy and convenient form to interpret, classify, store, retrieve and update” (Theoretical issues, 1998, Concepts). Knowledge is the third level of the model and is the collection of information that is obtained from several sources to produce a concept used to achieve a basis for logical decision-making. The information needs to be

For the electronic health record to be considered as a true clinical decision support system, it must be possible to access and integrate patients’ clinical information that is collected throughout their lives, guaranteeing up-to-date, safe and congruent information, immediately accessible at the place of care. Moreover, because of the considerable increase in the capacity to develop and manufacture systems that employ smart components highly integrated and miniaturized, wearable devices facilitate the home monitoring of patients with chronic diseases and their information should be integrated in existing electronic health records. Therefore, the interoperability is an essential requirement of eHealth to allow the integration of care into a

An interview with an Assistant Professor at Duke University Health System in the Department of Medicine, Maestro Care Provider Champion and Clinical Content Architect. This physician works to incorporate clinical decision support tools into the electronic health record at Duke Health System. He manages the best practice advisory committee that may provide a way to deploy alerts to clinicians at the point of care. Alerts with order sets and recommended actions are created and updated to notify providers of current patient care guidelines or patient safety concerns.

Clinical Decision Support System (CDSS) has potential chances to enhance general security, quality what's more, cost-adequacy of human services. The CDSS has existed for over four decades, yet its selection rate by therapeutic groups is not empowering even in the nations that have been a pioneer in creating them. At numerous locales, it was hazardous, slowed down in the arranging stages or never at any point endeavored. To date, CDSS is considered as an incompletely effective framework. A few current difficulties have not been enough tended to amid the improvement of CDSS. According to most recent research, the arrangements of difficulties are: enhance the human-PC interface,

Alert fatigue and using a clinical decision support system (CDS) in an electronic health record is a growing concern in health care. Although alerts and warnings in an EHR are well intended, the volume of alerts EHR end-users receive is surprising. The Agency for Healthcare Research and Quality (AHRQ) estimates that in some EHR end-users have the potential to receive over 100 CDS alerts per day (Agency for Healthcare Research and Quality [AHRQ], 2015, p. 1). This cause’s alert fatigue when the end-users become desentized to the alerts and even the most important alerts become meaningless.

TVGs support system when it comes to their supportive policies and guidelines they have a MSD book with all the residents care plans, if they have fall risks, if they are a one or two assist (that’s when one CNA or two are needed), whether they like showers or a bath. CNAs have a book where they record the input and output of the residents that is in each group that has to be recorded each night before your shift is over. They is a separate book that’s located on each floor with all the policies and procedures in it. There is now a system out that the nursing home I was employed at doesn’t have and need. Its called the Clinical decision support system (CDSS). The CDSS comes with an alert for weaken state, development in condition, constipation,

In the United State, hospitals, less than two-thirds of hospitals have any type of CDS. (Byrne et al., n.d.). We might be wondering why the use of CDC is low among health care provider, based on my study the following are some of the barriers in implantation of CDS: Usability issues (Byrne et al., n.d.). This include rate of the process of information, user what the information that he or she wanted as fasted rate as possible, it graphical User Interface is not as friendly as it should be. Secondary ,the CDS Alarms functionality include lists of possible diagnoses, drug interaction alerts, or preventive care reminders and the overused of theses alarm may lead to the clinician not paying too much attention to them as it would be seen as normal sound (Bolch, 2012).These are some of the way, in which these barrier can be remove, need for better user friendly design , if the interface is well design and easy to use more physician who like to use it in making clinical decision, There is needs for the vendor and researcher to address this design failure ("Clinical Decision Support (CDS) Initiative | AHRQ National Resource Center; Health Information Technology: Best Practices Transforming Quality, Safety, and Efficiency," 2014). It is imperative to customize CDS after it is implemented failure to do this can lead to failure. For example, disabling some of the alarm system that is redundant or lack practical value, and constantly training of clinician to ensure important reminder do receive necessary attention (Bolch,

The Computerized Provider Order Entry is effective program to help organization improve quality measures and financial margins. The CPOE is effective program; which monitors a hospitals current performance and calculates methods of improvement. For example, Trinity Hospital a leader in clinical intelligence to track and report across it members hospitals on systems wide quality measures (Balgrosky, 2015). The Clinical Provider Order Entry will help patients compare programs graded by the Center for Medicare & Medicaid and Hospital Quality Assurance. This program will further enhance the patient-centric model because patients will have comprehensive comparison of hospitals to make informed medical decision as to where they would like to receive treatment. The quality measures monitor readmission, complications, patient’s experience surveys and other categories. Patients are interested in receiving health care in top-notched care facilities that address their needs. Consumer needs are very important because translating into referrals by word-of-mouth or rankings. Technology plays a major role in an organization's success with supports Judy Murphy idea of enhancing patient’s health information technology

Clinical decision-support systems (CDSS) apply best-known medical knowledge to patient data for the purpose of generating case-specific decision-support advice. CDSS forms the cornerstone of health informatics research and practice. It is an embedded concept in almost all major clinical information systems and plays an instrumental role in helping health care achieve its ultimate goal: providing high quality patient care while, at the same time, assuring patient safety and reducing costs. This computer based systems designed to impact clinician decision making about individual patients at the point in time that these decisions are made. If used properly, CDSS have the potential to change the way medicine has been taught and

Reminders are generated by the Clinical Reminder System (CRS) and inform the provider of recommended actions in regards to tests that should be performed, vaccinations, and also have the ability to discuss the pros and cons of treatment plans (Zheng, n.d.). CRS is an evidence adaptive decision support system which supplies decision aids with a knowledge base which is constantly adapting to new research and evidence based medicine (Zheng, n.d.). CRS manages four chronic health conditions which are diabetes, asthma, hyperlipidemia, and hypertension. There are also four preventative care areas such as cervical cancer, breast cancer, influenza, and pneumonia (Zheng, n.d.). CRS is also real time with a wide diversity of patient data from other hospital systems, which include laboratory test results, vital signs, and disease diagnoses.

There are a lot of problems and challenges involved in implementing a clinical decision support system. It is important for medical staff (doctors, administrators etc.) to be an integral part in the implementation and development of CDSS. Our limited research concluded that acceptance of such technology is not easy amongst physicians. One of the main reasons for non acceptance is that the physicians want to be a standalone entity. We plan to investigate many challenges such as lack of technical expertise, cost, integration, misdiagnosis, speed etc involved in implementation of different types of CDSS in the health care industry today. Our research paper will focus on the different decision problems involved in these challenges.

Clinical decision making is a complicated process that depends on human capability to provide full attention to memorize, and create enormous amounts of data to all areas. IT systems are able to access information, arrange them, and recognize links between them. Clinicians often ‘know’ information such as a patient’s allergies, drug interaction and if that drug is on recall.

Having a single view of the patient and their treatment and recovery plan is invaluable in ascertaining which are the most and least effective tactics in treatment. The 360-degree view of the patient and the many processes supporting them is crucial for increasing the accuracy, effectiveness and performance of treatment programs over time (Blakeman, 1985). Computerized management systems are critical for organizing, analyzing and translating the massive amount of data captured on patients, treatment and recovery processes, and the use of supporting IT systems to optimize patient health and organizational provider performance (Peshek, Cubera, Gleespen, 2010). The ability to aggregate and intelligently use all available data, information, patient-based and process-generated data to deliver higher levels of quality care is possible when computerized management systems are used throughout healthcare organizations.