Clinical Decision Support Systems ( Cdss )

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Clinical Decision Support Systems (CDSS) can be described as information systems to improve the decision making ability of people interacting with it (Niès, Colombet et al. 2010). Hospitals with integrated Health Information Systems (HIS) are encouraged to utilize CDSS (Jonathan Teich 2012). Multiple fragments such as Electronic Health Record (EHR), laboratory information system, Computerized Physician Order Entry (CPOE), radiology information system and pharmacy information system combine together to form an integrated HIS (Niès, Colombet et al. 2010). Each piece of the HIS is essential to generate proper CDSS suggestions in the form of on screen alerts, that have been found to be most effective (Shojania, Jennings et al. 2009).…show more content…
2005). However, CDSS embedded into the integrated HIS can reduce the number of such repetitive tests (Bates, Kuperman et al. 1999, Neilson, Johnson et al. 2004). The objective of this literature review is to study the evidence of CDSS on reducing inappropriate laboratory testing. The literature review focuses on teaching hospital healthcare setting. The percentage and the effect of CDSS on reducing the number of inappropriate tests are reported. Also the financial effect of reduced laboratory testing is studied. BACKGROUND A considerable number of diagnostic tests ordered by teaching hospital can be considered unnecessary (Schroeder, Kenders et al. 1973, Eisenberg, Williams et al. 1977, Williams and Eisenberg 1986, Dorizzi, Dall 'Olio et al. 1996). Redundant test ordering is expensive resulting in excessive false-positive outcomes, leading to further causeless testing, treatment and expenses (Bates, Goldman et al. 1991). Despite extensive research on the redundant and excessive usage, test ordering has not declined much over the past decade (Axt-Adam, Van Der Wouden et al. 1993). Different types of interventions have been introduced to reduce the excessive test ordering, some of them include - incentives, rationing, education and feedback leading to 25% reduction for the intended test orderings (Detsky 1987). However, even the most effective interventions have irregular success and always the interventions are expensive in
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