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

It is important to understand the history of how the healthcare industry decided to embrace the use of computer databases. Typically healthcare was often the last to employ new technology; especially when it came to assembling and disseminating data. As a Director of HIM (Health Information Management) it would be beneficial to remember this as there will undoubtedly be some resistance when attempting to implement new and improved systems to track everything from patient outcomes and laboratory tests to prescriptions and medications.

Systems – this level includes “clinical decision support system (CDSS)”. This level is ranked the highest because evidence is acquired from point-of-care databases that are linked to electronic medical records of specific patients (2015).

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.

Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patient's life. CIS clinical information systems are "large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support". CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.

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.

In order to streamline implementation and utilization of the EHR, computers and servers need to be capable of handling the demands of the EHR, requiring a strong internet connection and a large storage capacity. Offices not only face the challenge of upgrading their existing operating system, but ensuring compatibility and linking to the new EHR databases that may also be located outside the facility. I believe a clinical decision support software may also be necessary to emphasize the quality of care that is expected of the physician, allowing them to gain and apply information to a patient’s case that can help them in their diagnoses and treatment

Statistics have shown that only 13 percent of doctors and 7.6 percent of hospitals have adopted extensive electronic record systems. Even more perplexing, the adoption rate is even lower for comprehensive systems such as clinical decision support, with rates around 4 percent for doctors and 1.5 percent for hospitals. Enhancing data exchange through a more secure network and improving patient care with the use of clinical decision support tools must become priority.

The Clinical Decision Support Systems have challenges to overcome such as information technology must be design a effective system which notify certain outlier medical information data input. This requires a very through collaboration between the Information Technology Department and the medical facility. Once the specified notifications are designed the medical facility will perform a test run to confirm accuracies and promptness of the required notifications. The next challenge with Clinical Decision

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.

As consumers demand more opportunities to use the internet. The internet is transforming the consumers as they interact with the health care system. Telemedicine for remote patient monitoring of patient health is increasing in use by doctors and health care providers. The internet is also transforming health care through electronic medical records. Records stored electronically boosts survival rates ad improves coordination by allowing facilities and medical providers access to share medical information with ease. An electronic medical record is the heart of any computerized information system in health care. In absence of this, modern technologies such as decision support systems cannot be integrated into the clinical workflow. Current Electronic medical records systems are delivering safe, high quality health care.

The greatest levels of credibility in the context of computerized management systems revolve around saving lives of patients and speeding up their recovery process. Studies of the effectiveness of computerized management systems illustrate that small increases in accuracy and stability of data on patient

The patient monitoring system defined in the problem was developed 5 years ago. That means it was developed somewhere in the year 2009. C32 was the standard at that time. Consolidated Clinical Document Architecture (CCDA) was not developed until 2011. This means that the system was never designed by keeping meaningful use of EHRs in mind. Hence, it should be difficult for the system to pass all the criteria of meaningful use. Since the criteria described in Stage 1 of meaningful use are present in Stage 2 as well, only Stage 2 will be discussed in the following section.