Clinical decision support capabilities of commercially-available clinical information systems (original) (raw)
Related papers
Journal of the American Medical Informatics Association : JAMIA, 2015
Clinical decision support (CDS) is essential for delivery of high-quality, cost-effective, and safe healthcare. The authors sought to evaluate the CDS capabilities across electronic health record (EHR) systems. We evaluated the CDS implementation capabilities of 8 Office of the National Coordinator for Health Information Technology Authorized Certification Body (ONC-ACB)-certified EHRs. Within each EHR, the authors attempted to implement 3 user-defined rules that utilized the various data and logic elements expected of typical EHRs and that represented clinically important evidenced-based care. The rules were: 1) if a patient has amiodarone on his or her active medication list and does not have a thyroid-stimulating hormone (TSH) result recorded in the last 12 months, suggest ordering a TSH; 2) if a patient has a hemoglobin A1c result >7% and does not have diabetes on his or her problem list, suggest adding diabetes to the problem list; and 3) if a patient has coronary artery dis...
It is observed that clinical decision support (CDS) and electronic health records (EHR) should be integrated so that their contribution to improving the quality of health care is enhanced. In this paper, we present results from a review on the related literature. The aim of this review was to find out to what extent CDS developers have actually considered EHR integration in developing CDS. We have also investigated how various clinical standards are taken into account by CDS developers.
Electronic Health Records and Clinical Decision Support Systems
Archives of Internal Medicine, 2011
Background: Electronic health records (EHRs) are increasingly used by US outpatient physicians. They could improve clinical care via clinical decision support (CDS) and electronic guideline-based reminders and alerts. Using nationally representative data, we tested the hypothesis that a higher quality of care would be associated with EHRs and CDS. Methods: We analyzed physician survey data on 255 402 ambulatory patient visits in nonfederal offices and hospitals from the 2005-2007 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. Based on 20 previously developed quality indicators, we assessed the relationship of EHRs and CDS to the provision of guideline-concordant care using multivariable logistic regression.
JOURNAL OF DECISION SYSTEMS, 2018
In assessing the benefits of using e-health systems, the main goal of this study is to evaluate the real use of the clinical decision support system (CDSS) between 2007 and 2014 in Canada’s healthcare sector. The quantitative method was based on data collected by the National Physician Survey in Canada. Results indicate that 63.8% of healthcare providers were using a CDSS at work in 2014 to help them in the decision-making process, a sixfold improvement since 2007. As for usage rate by sex, we found a statistically significant difference between men and women, with women from the Canadian physicians’ group reporting greater CDSS use than men. In all age groups, a higher percentage of younger physicians used a CDSS in their practice. A number of suggestions are put forth to improve technological infrastructure and reduce the gap among age groups, genders and specialties.
The clinical decision support consortium
Studies in health technology and informatics, 2009
Clinical decision support (CDS) can impact the outcomes of care when used at the point of care in electronic medical records (EMR). CDS has been shown to increase quality and patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Systematic reviews have shown that CDS can be useful across a variety of clinical purposes and topics. Despite broad national policy objectives to increase EMR adoption in the US, current adoption of advanced clinical decision support is limited due to a variety of reasons, including: limited implementation of EMR, CPOE, PHR, etc., difficulty developing clinical practice guidelines ready for implementation in EMR, lack of standards, absence of a central repository or knowledge resource, poor support for CDS in commercial EMRs, challenges in integrating CDS into the clinical workflow, and limited understanding of organizational and cultural issues relating to clinical decision support. To better understand and overcome these barriers, and accelerate the translation of clinical practice guideline knowledge into CDS in EMRs, the CDS Consortium is established to assess, define, demonstrate, and evaluate best practices for knowledge management and clinical decision support in healthcare information technology at scale -across multiple ambulatory care settings and EHR technology platforms.
AMIA Annual Symposium Proceedings, 2007
Background: Ample evidence exists that clinical decision support (CDS) can improve clinician performance. Nevertheless, additional evidence demonstrates that clinicians still do not perform adequately in many instances. This suggests an ongoing need for implementation of CDS, in turn prompting development of a roadmap for national action regarding CDS. Objective: Develop practical advice to aid CDS implementation in order to improve clinician performance. Method: Structured group interview during a roundtable ...
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium, 2012
A standards-based, service-oriented architecture for clinical decision support (CDS) has the potential to significantly enhance CDS scalability and robustness. To enable such a CDS architecture, the Health Level 7 CDS Work Group reviewed the literature, hosted multi-stakeholder discussions, and consulted domain experts to identify and prioritize the services and capabilities required from clinical information systems (CISs) to enable serviceoriented CDS. In addition, relevant available standards were identified. Through this process, ten CIS services and eight CIS capabilities were identified as being important for enabling scalable, service-oriented CDS. In particular, through a survey of 46 domain experts, five services and capabilities were identified as being especially critical: 1) the use of standard information models and terminologies; 2) the ability to leverage a Decision Support Service (DSS); 3) support for a clinical data query service; 4) support for an event subscription and notification service; and 5) support for a user communication service.