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CDS 101 Overview

Page history last edited by David A Collins 11 years, 5 months ago

 

CDS Background

 

 

§         Q: What is Clinical Decision Support (CDS)?

§         A: Clinical Decision Support, or CDS

o        CDS is defined as health information technology 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..1  CDS delivers information highly relevant to the current situation, and presented for the most effective use.2

o       CDS includes: alerts and reminders, clinical guidelines, order sets, patient data reports and dashboards, documentation templates, diagnostic support, reference information delivered, and other tools to support decisions within clinical workflow.

 

 

§         Q: What are the goals of CDS?

§         A:

o        Provide the right information, to the right person, in the right format, through the right channel, at the right point in clinical workflow to improve health and healthcare decisions and outcomes.2 This ‘CDS Five Rights’ approach is also a framework for setting up and optimizing CDS interventions to address priority objectives.

o        CDS interventions can:

§         Detect potential safety and quality problems and help prevent them

§         Detect inappropriate utilization of services, medications, and supplies

§         Foster the greater use of evidence-based medicine principles and guidelines

§         Organize, optimize and help operationalize the details of a plan of care

§         Help gather and present data needed to execute this plan

-    Ensure that the best clinical knowledge and recommendations are utilized to improve health management decisions by clinicians and patients 

 

CDS and Meaningful Use

  • Meaningful Meaningful Use: What it has to do with CDS and why failure is not an option

http://www.himss.org/CI_Insights/HIMSSClinicalInformaticsInsights.asp?date=20091214

 

 

 

Types of Decision Support Systems

1.       Diagnostic Decision Support (systems to enhance diagnostic accuracy)

2.       Medication Decision Support (medication alerts, interactions, dosing formulas etc)

3.       Preventive Decision Support (optimal preventive care based on patient factors)

4.       Testing Decision Support (patient specific diagnostic laboratory or radiologic tests)

5.       Management Decision Support (systems providing therapy and management guidance based on patient factors)

6.    Surgical Decision Support

 

 

Additional “Decision Support”

                       

 1. Referential Medical Knowledge                                   

 2. Disease Oriented Knowledge Resources  (UpToDate, MDConsult, Dynamed etc)                                   

 3. Medication Oriented Knowledge Resources (epocrates, etc)                                   

 4.  Medical Calculators

 5. Optimal Management, Testing, Therapy  and Prevention:  Guidelines

 6. Optimal Management, Testing, Therapy  and Prevention:  Order Sets

 

 

Website

- Meaningful Use and Decision Support (extract from wiki content already posted)

- Core messaging: How do I design CDS?  How do I deploy CDS?   What are categories of CDS? (categorize by need)

- Ambulatory systems - systems with CDS --- already turned on, how to use, what to do with it?

- Key examples

- Testing, i.e., "use cases"; does CDS do what it needs to do

- Links to wiki

 

Wiki

- eLearning Academy outline

- subspecialties

- populate with real-world examples, e.g., videos

- who are vendors that match to the types of decision support

 

 

 

 

 

 

 

 

 

 

Comments (3)

Jerry Osheroff said

at 10:28 am on Feb 4, 2010

Distinction between 'types' and 'non-computational' not entirely clear. May be 2 orthogonal axes - one covering intervention types (see tables in CDS guides that list 6 core types and many subtypes) and another covering type of care processes/decisions supported - e.g. diagnosis, preventive care, condition management, etc.

Art Papier said

at 1:06 pm on Mar 21, 2010

There is a problem with the starting defintion...."CDS is defined as health information technology functionality that builds upon the foundation of an EHR" The term CDS is agnostic to whether CDS is integrated into a record or not. We have many clinicians successfully using our CDS on smartphones now, the workflow and thoughflow for numerous physicians is the mobile device....it will be years before the smartphone is integrated into the record. We need to change this to something like:

CDS is defined as health information technology functionality that provides persons involved in care processes with person-specific information, intelligently filtered and organized, at appropriate times, to enhance health and health care..1 CDS delivers information highly relevant to the current situation, and presented for the most effective use.2

Jerry Osheroff said

at 8:28 am on Mar 22, 2010

I agree with you art. The stuff after "...builds upon the foundation of an EHR" is actually our defintion from the CDS guides and roadmap, and we specifically wanted to be agnostic about not only integration with EHRs, but also computers. Taken to extremes, our original CDS definition doesn't even require electricity! The defintion cited above is what's in the meaningful us NPRM, so that will exert significant influence in the healthcare/CDS landscape. Perhaps we could point out here that, although meaningful use is (according to the language of the legislation and regulation) largely about EHRs, there are important CDS tools and opportunities beyond that particular channel of the 'CDS 5 rights.'

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