Clinical Decision Support Systems ( Cdss )

UHN in Toronto is a major community care network that reaches out to and provides care to the masses. However in order to provide this kind of care they must have a very powerful decision support system. UHN utilizes an advanced CPR to support computerized physician order entry (CPOE). (Wu, Perters, & Morgan, 2002) A CPR system is a computer-based patient record system. A CPR system must provide a comprehensive clinical decision support it must include both a patient focus and a population focus. The physical computer system that is installed on the computers at UHN is called Patient 1® which is a clinical information system developed by Atlanta Based Per-Se

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).

Clinical outcomes includes improvement in quality care, decrease in medication errors and other improvements in patient level measures that defines the appropriateness of care. Organization outcome measures financial and operational performance and satisfaction among clinicians and patients who use EHRs. Finally, societal outcomes includes improvement in research and achieving population health. EHR improves clinical outcome by providing quality and safest care to the patients. EHR with CDS tool allow the increased use of evidence based clinical guidelines and effective care. EHR use can improve patient care, a study was conducted to assess the clinical benefits of physician reported EHR. The study resulted that, most physicians using EHR enhanced overall patient care (78%), helped them to access the patients chart remotely (81%) and gave potential medication error alert (65%) and critical lab values (62%)(King, Patel, Jamoom, & Furukawa, 2013). Organizational and societal outcome includes increased revenue, improved regulatory compliance, averted costs, better capability to conduct research, and improved job satisfaction among physicians (Menachemi & Collum,

The value of Clinical Decision Support Systems is having additional avenues monitoring patient’s data input. The Clinical Decision Support Systems are offering notifications of patient’s record data to specified department or medical personal.

patient satisfaction, and improve efficiency of care. The use of clinical decision support tools can

Despite their potential to significantly improve health care, advanced clinical decision support (CDS) capabilities are not widely available in the clinical setting. An important reason for this limited availability of CDS capabilities is the application-specific and institution-specific nature of most current CDS implementations. There is a critical need to enable CDS capabilities on a much larger scale is the development and adoption of standards that enable current and emerging CDS resources to be more effectively leveraged across multiple applications and care settings. Standards required for such effective scaling of CDS include (i) standard terminologies and information models to represent and communicate about health care data; (ii) standard approaches to representing clinical knowledge in both human-readable and machine-executable formats; and (iii) standard approaches for

The benefits of health information technology (HIT) systems have been well documented in exisiting literature. In fact, (HIT) has been shown to improve “timeliness, availbalility, completedness, legibility, and (ideally) accuracy” of health information (Peters & Khan, 2014). HIT systems applications such as Computerized Order Entery (COE) have been linked with reducing medication prescribing errors (Peters & Khan, 2014). Additionally, Clinical Decision Support (CDS) systems generate alerts and reminders intended to encourage providers to adhere to clinical practive guidelines thus standardizing care. These and many other features of HIT systems serve to enhance the delivery and quality of care (Paul et al.,

The role of nurses, relative to an EHR interfacing with CDSS, is clinical documentation, interpret other clinical data, utilize the interpretation of the clinical documentation into plan of care, and simultaneously identify patterns of outcomes for given plans with similar clinical condition of patients. CDSS alleviates stress for less experienced nurses with limited knowledge of clinical care patterns, and helps them arrive at appropriate decisions for care. Thus, acceptance and use of CDSS is more likely to occur in nursing fields where clinical care patterns often vary, or with areas employing less experienced nursing professionals. Alert fatigue occurs with overusing repeated algorithms for common clinical care decision paths; therefore,

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

Health Informatics created two main categories such as clinical and administrative information systems to meet the needs of one or more department within the health care organization. For the clinical information system, it is set to meet the needs in improving patient care. Therefore, the clinical information system (CIS) categories provide nurses information systems (NIS) that support the way nurses documents the care that given to the patients. However, to improve the delivery of nursing care, the healthcare organization must adopt a computer system that can successfully incorporate tools that will benefit nursing. There is two vendors’ software that implies these characteristics for the

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.

Interesting discussion post! Yes, the RxWriter project should consider the special need of all stakeholders involve. However, the project management team must not lose sight of the overall mission of project which to ensure medication prescription safety. Ensuring the project accomplish its primary goal will require a well integrated approach that will enable physician to order medication and variety of tests neccesary to treat patient's condition. The addition of the Clinical Decision Support System (CDSS) will further enhance the safety feature of the electronic prescription system, but the CDSS should not be implement in a way that will impede clinician judgement or interfere with workflow as this can create an avenue for

CDS vendors can provide end-user configuration tools that allow particular decision support features to be modified, or turned on and off. Still, many end-user organizations have reported that, when used as the primary source for CDS in clinical systems, commercial knowledge bases produce an excessive amount of alerts. Many of which are clinically unhelpful as well. Examples of these

End users will be interviewed to gather information on requirements. End users include physicians, nurses, social workers, physical therapists, dietitians, pharmacists, and quality assurance members. End user workflows and processes will be observed and information will also be obtained from surveys and focus groups in order to determine the impact of the CDS tool. Heart Failure patients will be the only patient population targeted by this

Coiera pointed some areas in healthcare practice that could be affected by the use of CDSS, including support decisions with clinical evidence, disease diagnosis and control of prescription medications (2015). Using CDSS has been associated with evidence of potential improvements in health care quality. However, to achieve this improvement in practice, some requirements, such as accurate and knowledge-based evidence, are needed (Sim et al., 2001). Sim et al. concluded that this evidence could provide a quick and reliable answer, and more efficiency would occur if CDSS linked with patients’ EHRs to assist individuals based on their medical histories and plans. To evaluate the actual impact of using evidence in CDSS on patients’ outcome and