Question

Imagine that you’ve been appointed Director of Clinical Decision Support at a healthcare delivery system. The healthcare system consists of several large hospitals and multiple outpatient clinics and uses the same EHR system across the enterprise. There has been limited CDS activity prior to your arrival. Now with the increasing need to provide increased care value, the appropriate use of CDS is an institutional priority. The current CDS available at your institution consists primarily of off the shelf drug-drug interactions and drug allergy alerting, which is the source of significant clinician complaints due to the rate of false positive alerts. There is a strong sense within the institution's administration that IT in general and CDS specifically should be leveraged to improve care value and to enable the institution to influence its clinical practice patterns more systematically and more rapidly. You have a reasonable budget and adequate staff to make meaningful changes and you do have support from key institutional stakeholders, including healthcare system executives, the nursing informatics officer, and the chief medical informatics officer. You’ve been asked to devise a strategic plan for CDS at your institution within 3 months of your arrival and to have concrete ‘wins’ within 12-18 months. Describe the approaches you’d use to ensure that all aspects of patient care were considered when developing a CDS system. How would you prioritize the efforts of your CDS team? Potential areas on which to focus include areas in which payment rates are tied to national quality measures, CDS intervention that meet Meaningful Use requirements, readmissions for congestive heart failure and other care events for which payers are increasingly not reimbursing, and areas that have been identified as institutional priorities for clinical improvement. How would you balance the need to deliver desired CDS capabilities quickly against the benefits of establishing robust infrastructure to enable future deliverables to be implemented more quickly? Identify one area for quality and value improvement. Define the CDS interventions that you’d implement to address this area of need. Describe how this approach aligns with the best practices discussed in this chapter, such as the CDS Five Rights, the CDS 10 commandments, and the desire to use standards-based, scalable approaches. How would you systematically measure the impact of these CDS interventions? Outline a usability test for one module of your current EHR.

Answer 1

tion

CDS(Clinical Decision Support Systems) provides health-related information to the healthcare professionals, patients and families in order to make decisions relevant to the patient care. CDS utilizes the different tools like Clinical guidelines, EHR, computerized alerts, Reminders to health care suppliers and consumers.

CDS is the modified IT health system that incorporates the knowledge and data which allows the access of concerned personnel. It helps the workflow, and the data is formulated in such a way that it helps easy decision making.

There are many benefits like,

Improved quality of care

Minimizes the time for decision

Effective use of resources

Provide standardized care

Easy accessibility through HER

Easy exchange of information

Provider and patient satisfaction

Cost-effectiveness

Determining the approaches for CDs is very important and make sure that all the staffs are involved in it to ensure completeness.

Coordinate all staffs.

Examine the current situation.

Plan to modify the effectiveness

Testing and replanning is also necessary

Different features and fixes are considered

Standardized order sets and reminders make sure the inclusion