A Detailed Look Into the World of Clinical Decision Support Systems

As healthcare organizations become more and more advanced in their utilization of technology, they are now able to help their patients in a more efficient and effective manner. The deployment of clinical decision support systems (CDSS) are key to ensuring that the right healthcare is provided to the right patient at the right time.

Clinical decision support is the ability of an organization to deliver the best healthcare by having the necessary information at the appropriate time so that they can provide the optimal treatment for their patient’s needs. Clinical decisions that doctors make as a result of clinical decision support systems are extremely accurate and effective due to the amount of tools available. With these tools, doctors are able to get the necessary information with a list of possible treatments, prognosis, and reminders for any patient’s condition.

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The best part about this clinical support system is that it gives healthcare practitioners the ability to input and update new information in the system’s database that other practitioners will be able to utilize in giving the best healthcare possible.

What is Clinical Decision Support?

In the past, doctors had to make clinical decisions based on their individual experience, knowledge and skill. Many of these doctors encountered patients with conditions they were not fully equipped to handle due to lack of experience or know-how. This resulted in doctors making wrong decisions for patient treatment because of their lack of knowledge.

With the clinical decision support systems today, doctors now have the right information and knowledge giving them the best recorded treatment for any given patient condition. Healthcare providers can find the necessary information to properly instruct their nurses and assistants in aiding patients through the entire treatment process.

As the field of medicine is getting more and more complex, there are constantly new guidelines and rules in how to conduct specific treatments that are released on a monthly basis. This new information entails a lot of details and nuances that are hard to keep in mind for many doctors. Clinical decision support gives doctors that little extra assistance to make better decisions based on the information updated into these new guidelines and rules.

Why the Need for Clinical Decision Support Systems?

With the advancement in technology, most healthcare organizations have made the switch from paper records to electronic health records, which are digital records of all information regarding their specific patients. The recording of this information in a digital platform allows healthcare practitioners to gather real-time patient information to make the best prognosis or diagnosis possible.

With clinical decision support systems, the use of electronic healthcare records improves significantly as information is made available at the click of a mouse. Another facet of healthcare that clinical decision support systems improves significantly is imaging, which many organizations felt were becoming too expensive and costly for their patients.

Benefits of Clinical Decision Support Systems

Organizations that utilize clinical decision support systems become more efficient and effective at administering the right treatment and healthcare plan for their patients. They are also able to crosscheck and verify with other existing systems containing vital information that healthcare providers need in making the best possible decision for the patients. Other benefits that organizations receive for the use of clinical decision support systems are:

• Improved patient outcomes
• Increased hospital efficiency
• Improved healthcare
• Provides physicians with alternative treatment
• Gathers all data in one database
• Saves time and money
• No forgotten or lost information

Eight Examples of Clinical Decision Support Systems

There are many efficient and effective clinical decision support systems used by most healthcare organizations today. These systems all have one thing in common: a deep database of clinical information that is geared at helping doctors make the best decisions for their patients. Here are eight of the most popular clinical decision support systems.

1. Micromedex 2.0

One of the more popular clinical decision support systems in the world today is Micromedex 2.0. This system is a highly interactive tool that allows healthcare practitioners to get instant information not just on their computers but on their mobile devices as well.

Micromedex 2.0 comes available with an app that doctors can install on their mobile devices. Among the tools offered by this system are:

• Health and Disease Management
• Medication Safety
• Toxicology
• Patient Education

IndiGO is a clinical decision support system developed by Archimedes founder Dr. David Eddy. The system works to analyze physiological, clinical and administrative data that it stores into its database. Healthcare organizations that use this system can put together customized treatments centered on a patient’s conditions.

DiagnosisOne is another clinical decision support system that works to help practitioners in recording and surveying health records. This system is very effective for analytics as it utilizes smartConsult CDS module scans that help doctors formulate the best treatment plans for their patients. This system is designed to provide:

• Patient Education
• Physician Productivity
• Health Information Exchange

Auminence is a clinical decision support system that specializes in diagnostics. It was developed by Autonomy Health, a known subsidiary of Hewlett-Packard. This system concentrates more on the diagnostic side while still providing a very deep database of clinical knowledge to healthcare organizations. It works on a platform known as “Meaning Based Healthcare” which offers:

• Symptoms Analysis
• Physician Knowledge
• Patient History Analysis

The clinical decision support system known as Elsevier Clinical Decision Support is an effective system developed by the Reed Elsevier Group. This system contains a massive database of medical books, journals, and online reference tools, particularly MDConsult, that offers:

• Clinical Content
• Learning and Performance Management
• Analytics
• Reports
• Drug Reference
• Decision Support

Developed by Massachusetts General Hospital in 1986, DXplain is one of the oldest clinical decision support systems that are still used by many organizations today. This system contains one of the largest databases of information which includes diseases, data points, and clinical findings among others. It also offers:

• Doctor Observations
• Test Results
• Diagnosis

Problem-Knowledge Coupling (PKC) is a good clinical decision support system developed Dr. Lawrence Weed. This system caters around the “coupling” of available medical knowledge and customizing the information according to each patient’s condition, which is perceived by Dr. Weed to be more effective and accurate due to evidence-based medicine being too unreliable. PKC offers many tools such as:

• Objective Planning
• Subjective Planning
• Analytical Planning

A very practical and intuitive CDSS tool that many organizations use is the Isabel system, which is more of a diagnostic clinical decision support system tool. The Isabel offers practitioners with information about the rarest and most uncommon conditions that have been recorded. In fact, the system has a database of 100,000 documents. Through this information, doctors who have patients undergoing a rare disease will have more than adequate information that may help them arrive at a more accurate diagnosis and proceed with the best treatment possible. Among the services offered by Isabel are:

• Web-based Checklist
• List of Symptoms
• Alternative Medications and Treatment
• Test Results

Three Fundamentals that CDSS Programs Must Follow

Because medicine and technology today go hand-in-hand, clinical decision support systems are continuously getting more advanced than ever. With the various systems that most healthcare organizations use, there are three fundamental aspects that these programs follow. These fundamentals act as the primary blueprint for which a CDSS program is developed. These aspects are as follows:

1. Knowledge Based Information

Through the information gathered in the databases of clinical decision support systems, physicians will be able to have the right information on-hand to be able to correctly and efficiently diagnose and treat their patients.

All patients have their own medical conditions that physicians must document in real-time. When these patients return for treatment, the clinical decision support system will already have an updated file on the progress of their treatment. In the event that a patient’s treatment is not proving effective, physicians will have other case studies and alternative treatment information that they can use in order to solve the needs of their patient’s condition.

All clinical decision support systems are basically software that have the ability of providing information to their users. Many of these systems communicate to doctors by presenting information such as past test results, drug references, symptoms analyses and doctor-based observations. Many of them even include a patient education program where sufferers can gain education on why they have their condition and how they can go about treatment in the best possible manner so as to maintain an optimal quality of life.

Types of Clinical Decision Support Systems

There are important aspects that physicians need to consider before choosing a specific clinical decision support system. Doctors must first identify what target area of care they will be providing to their patients. Once they have identified this, their clinic can now choose the best clinical decision support system suitable to that specific target area. Once implemented, the program will improve overall efficiency of care as well as aid doctors in identifying their patients’ disease at a very early stage. It will also aid in accurate diagnosis and protocol-based treatment as well as prevent dangerous adverse reactions to treatment.

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Clinical decision support systems used by clinics today target the following areas of care:

• Preventative Care. Preventative care as a target area for clinics must involve disease management, screening and immunization guidelines for secondary disease prevention.

• Diagnosis. CDSS programs that deal with diagnostics allow clinics to have information on-hand that provide suggestions for possible diagnoses customized to a specific patient’s symptoms and signs.

• Planning and Implementing Treatment. This CDSS program provides clinics with treatment guidelines for specific diagnoses, drug-drug interactions, drug dosage and other recommendations.

• Follow-up Management. This type of CDSS program provides clinics with corollary orders as well as reminders for drug adverse event monitoring.

• Hospital Provider Efficiency. Clinics use this CDSS tool to create suitable care plans for their patients to shorten or minimize their length of stay.

• Cost Reduction. This CDSS program used by clinics improves patient experience substantially as it provides duplicate testing alerts, reminders and drug formulary guidelines.