Clinical Decision Support advisories illuminate more at the point of care
For the most part, point of care health information technology has operated on an information input basis. Big databases store health information, and while it sure beats paper, few systems outside of billing have been making sense of the data we worked so hard to enter.
Recently, however, big data is often illuminating the point of care through technology enabled with Clinical Decision Support (CDS). CDS is part of the data science era of HIT, and is a large component of the return on investment of structured medical data entry.
CDS comes in many flavors, and to help support quality care delivery, Practice Fusion has deployed 7 clinical decision support advisories, initially targeting by meaningful use requirements and clinical quality measures. These advisories appear at the top of the chart note interface, based on the patient’s medical record including, demographics, diagnoses, medications, lab results and others. More than just flashing alerts, CDS has the potential to transform care.
Gain another set of eyes
Most physicians know their patients’ clinical needs backwards and forwards, but there are those times cognitive burdens shift, such as when seeing a colleague’s patient or being engrossed in a patient’s urgent acute issue. Nudges from CDS alerts and advisories can especially add value with important considerations that may not be top of mind. When properly implemented, CDS alerts can reduce the chance of missing an important lab test, drug interaction, or potential complication.
Learn new insights
CDS advisories allow you to learn more about your patients. The time spent hunting through the chart for the last diabetic eye or foot exam can be better used getting to know about the patient’s individual issues. CDS advisories will let you know when it’s time for your patient’s diabetic eye or foot exam – and in certain cases, when to check the Hgb A1c.
Improve quality reporting
We currently trigger our CDS advisories based on some of the meaningful use and PQRS CQMs. In addition to improving care for individual patients, CDS advisories can help make quality measurement and monitoring part of your workflow and boost outcomes for your whole patient population.
The initial deployment is not fit for all, and many advisories don’t apply to every practice. To avoid alert fatigue, turn off the ones you don’t need, especially if they do not fall under the scope of your practice. However, please note that Meaningful Use requirements stipulate that at least 1 alert (stage 1) or 5 alerts (stage 2) be activated for the entirety of the reporting period. New alerts will be continuously be rolled out and will initially be focused on preventive care.
CDS advisories will never replace the judgement and medical decision making of the provider. While we’re not at the point of CDS creating comprehensive personalized treatment plans from big data, that vision is not far away. We look forward to the stage when CDS alerts are individually tuned by big data modeling for individual patients, and we become a continuous learning healthcare system.