Materials and Methods:
Literature review of the growth and development in the sector
of Information technology used in medicine.
CDSS provide physicians, caregivers and also patients with the clinical knowledge needed
and patient and/or disease specific information to help
them make effective decisions that would
enhance patient care and improve clinical outcomes. CDSS include a wide range of variable tools
and interventions such as computerized alerts and reminders, clinical guidelines, clinical
pathways, order sets, patient data reports and dashboards, documentation templates, diagnostic
support, and clinical workflow tools. A CDSS actually is any computer system designed to help
healthcare professionals make clinical decisions through managing clinical data or medical
knowledge. Therapeutic CDSS can minimize errors by alerting the physician to potentially
dangerous drug interactions while diagnostic CDSS have also been shown to improve physician
diagnosis process and decision making in terms of both effectiveness and efficiency. Basic CDSS
provide functions of checking on drug-to-drug interactions, duplicate therapy, drug allergies and
dosing. Advanced CDSS provide more in depth advice and functions such as checking on
medication contra-indications, individualized dosing support during renal function impairment or
guidance for medication related laboratory testing. CDSS are able to present the best evidence-
based practice automatically, without requiring extra thought or work. This allows the health
professionals to focus on
those areas of special need and adjust care to each individual patient.
This not only increases patient safety, but also physician’s safety by reducing the risk on
malpractice. CDS Success stories from the field: South Omaha Medical Associates (SOMA) is a
family-owned, family-
operated clinic that is centrally located in South Omaha, Nebraska. It has a
higher percentage of low-income patients than clinics in surrounding areas. SOMA collaborated
with the Nebraska Department of Health and Human Services, Doug
las County Health
Department, and Wide River Health Information Technology to assess its technology needs and
make plans to implement CDSS.
Results:
The clinic increased its use of EHRs and implemented systems to better identify
patients with undiagnosed hypertension, increase use and monitoring of clinical quality measures,
and increase use of clinically supported self-measured blood pressure monitoring. These changes
improved workflow at the clinic and led to a 25% increase in patient visits since the st
art of the
collaboration.
Conclusion:
Besides the lack of well-described success factors, an often-mentioned
barrier to implementation is the low Computer skills among physicians. This must be carefully
taken into account within the design of the CDSS ale
rts. New generation physicians, like medical
students and junior physicians, may bring a higher level of computer Literacy to clinical practice
and stimulate implementation of a CDSS in practice.
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