Clinical Decision Support by Ashley Cephas

Nelson & Staggers (2014) define, clinical decision support as tools and applications that assist the healthcare provider with some aspect of clinical decision making. (p. 509)

Kawamoto & Del Fiol (2014) "Since shortly after computers were introduced in clinical settings in the 1960s and 1970s, CDS has been shown to be a powerful tool for positively affecting care delivery and patient outcomes." (p. 174)
Patient care considerations
These are the essential items on focusing when incorporating patient centered care with Clinical decision support
Clinical Decision Support Team

Wu, Davis, & Bell (2012) note, “Beyond design considerations, two overall themes emerged related to implementation: 1) the need for continual system improvements, and 2) effective user training that addresses individual and organizational issues during adoption.” (p.8)

Payments 

Q: How is CDS defined for purposes of the meaningful use program?

A: The concept of CDS for Meaningful Use encompasses a wide range of information, which can be presented to providers, clinical/support staff, patients, and/or other caregivers at various points in time. Auditors should consider ONC and CMS’ desire to encourage innovative efforts to use CDS to improve care quality, efficiency, and outcomes, and should use the Meaningful Use definition of CDS as an evaluation guide: “HIT functionality that builds upon the foundation of an EHR to provide persons involved in care processes with general and person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and health care.” (Obtained from HealthIT.gov)

National Quality Measures

What are Quality Measures?

Quality measures are tools that help us measure or quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality health care and/or that relate to one or more quality goals for health care. These goals include: effective, safe, efficient, patient-centered, equitable, and timely care. (obtained from: CMS.gov)

Readmission rates among clients with diagnosis of cardiac heart failure

Plan of action to reduce re-admissions of clients with CHF

This model demonstrates the power of clinical decision support from the physicians point-of-view
How fast can we efficiently and beneficially incorporate CDS in the current EHR system? 
Distributing information about CDS to interdisciplinary healthcare professionals

Areas for Improvement 

Kawamoto & Del Fiol (2014) write, “another growing area of is CDS interventions to promote patient centered (PCC) defined by the IOM as “care that is respectful of and responsive to individual patient values guide all clinical decisions.”” (p. 174)
It takes a medical village to provide quality patient centered care

https://www.healthit.gov/sites/default/files/clinicaldecisionsupport_tipsheet.pdf

References

Nelson, R. & Staggers, N. (2014). Health informatics: An interprofessional approach. St. Louis, MO. Mosby. Elsevier.

Ojeleye, O., & Jani, Y. (2016). Ensuring effective computerised clinical decision support. Prescriber, 27(5), 54-56. doi:10.1002/psb.1464

Wu, H. W., Davis, P. K., & Bell, D. S. (2012). Advancing clinical decision support using lessons from outside of healthcare: An interdisciplinary systematic review. BMC Medical Informatics and Decision Making, 12(1), 90. doi:10.1186/1472-6947-12-90

Clinical Decision Support: More than Just ‘Alerts’ Tipsheet. (2017, July). Retrieved March 24, 2017, from https://www.healthit.gov/sites/default/files/clinicaldecisionsupport_tipsheet.pdf

Quality Measures. (2017, February 14). Retrieved March 24, 2017, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/index.html?redirect=/qualitymeasures/

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