Implement five clinical decision support rules


   “One CDS rule” as required by MU proposed regulations [The final rule decreased the requirement to 1 CDS rule]

 

Return to CDS and meaningful use home page 

 

 

In the coming months the CDS TF hopes to stimulate rich experience sharing and best practices around issues such as:

 

1.      What topics are being considered for the 1 CDS rule in your organization?

            a)  Upon discharging patients with diagnosis of Congestive Heart Failure, the physician is prompted  to use the CHF Discharge Order set, which drives physicians to address key measure components with hard stops. 1) ACEI or ARB on discharge or specify reason not ordered and other measures

 

            b)  Within admsiion order sets, physicians are prompted to order VTE prophylaxis based on risk assessment for patients>18 yrs of age and non-psychiatric patients.  If they do not order VTE prophylaxis for the patient they are prompted to provide a reason why VTE prophylaxis is not ordered.  At 24 hours, the system checks to see if VTE prophylaxis  (or a contraindication provided) is not ordered), and fires a BPA if there is not such an order.

 

          c)   Upon discharging patients with diagnosis of Acute MI, the physician is prompted  to use the Acute MI Discharge Order set, which drives physicians to address key measure components with hard stops. 1) Antiplatelet drugs prescribed or reason not ordered provided.

 

          d)   Upon discharging patients with diagnosis of Ischemic Stroke, the physician is prompted  to use the Stroke Discharge Order set, which drives physicians to address key measure components with hard stops. 1) Antiplatelet drugs prescribed or reasonn not ordered provided and other measures

 

          e)  For post-surgical patients, physicians are prompted to reevaluate the ongoing need for indwelling urinary catheter after 24 hours post insertion, and they must either discontinue the catheter or provide a reason not to discontinue the catheter.

 

          a)  

 

 

2.      What is the process for getting there, e.g. governance around selecting rules?

 

3.      Who’s driving the process (CMIO, CMO, IT, other)?

 

4.      What are the criteria for selecting the specific rules on which you will focus?

 

5.      How will these rules for MU integrate with other quality improvement/reporting activities already underway?

 

6.      How will your organization ensure that the rules do more good than harm, e.g. avoiding alert fatigue, etc.